PrEP

Comments on USPSTF draft research plan on PrEP

The HIV+Hepatitis Policy Institute thanks you for the opportunity to comment on the U.S. Preventive Services Task Force (USPSTF) Draft Recommendation Statement: Prevention of Human Immunodeficiency Virus (HIV) Infection: Preexposure Prophylaxis (PrEP). On October 1, 2022, HIV+Hep submitted a request, supported by 62 additional organizations, asking the USPSTF to update the existing PrEP recommendation to include long-acting injectable PrEP. We commend you for conducting and completing this timely and thorough update.

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Letter on MassHealth coverage of long-acting injectable PrEP

A number of Massachusetts-based providers, community-based organizations and clinical sites joined us in writing to you in August 2022 to express our concern that MassHealth had not yet added cabotegravir, a new long-acting injectable form of pre-exposure prophylaxis (PrEP) to prevent HIV, to its formulary, and to urge MassHealth to make sure it is available without any barriers to access, such as utilization management or prior authorization requirements. (A copy of the August letter is attached.)

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HIV/AIDS groups letter in support of MassHealth making injectable long-acting PrEP available without barriers

HIV/AIDS groups are concerned that MassHealth (Massachusetts Medicaid) has not yet added cabotegravir, a new long-acting injectable form of pre-exposure prophylaxis (PrEP) to prevent HIV, to its formulary. We urge MassHealth to make sure injectable long-acting cabotegravir as PrEP is available on formulary without any barriers to access, such as utilization management or prior authorization requirements.

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64 organizations request expedited Medicare National Coverage Determination for long-acting injectable PrEP

We are pleased that the Centers for Medicare and Medicaid Services (CMS) has accepted a request for a National Coverage Determination (NCD) for cabotegravir, a new long-acting injectable form of pre-exposure prophylaxis (PrEP) to prevent HIV.  A National Coverage Determination is the only pathway to coverage under Medicare Part B for a provider-administered drug.  We have, however, been disappointed to learn that CMS has given no timeline for action on this National Coverage Determination, which will make this new long-acting PrEP medication out of reach for potential PrEP users.  Combined with a USPSTF recommendation, an NCD will also make the drug available to Medicare Part B beneficiaries without cost-sharing, thus eliminating one of the biggest barriers to PrEP uptake.

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