Health: Private Insurers Might Soon Be Required To Cover PrEP
Image credit: NIAID
As revolutionary as PrEP has been in changing the way we manage HIV, its high price has kept it from reaching the communities that are most at risk. However, a recent Grade A recommendation awarded by the United States Prevention Services Task Force (USPSTF) means that private insurers are now required by law to pay for PrEP. And they’re required to do it without having co-insurance costs, co-pays, or deductibles be shouldered by the consumer.
This is because the Affordable Care Act prohibits insurers from asking for cost-sharing or co-payments from those using Grade A or Grade B recommended strategies.
Currently, users of private or commercial insurance can have co-payments that range from $50 to $500. Those covered by Medicaid and other government programs don’t have any co-payments to worry about when it comes to PrEP.
Doctors Rochelle Walensky and David Paltiel lauded the move in an editorial published in the Journal of the American Medical Association, saying: “The significance of the new recommendations lies in the large number of individuals in the United States whose insurance coverage for HIV preventive services, notably PrEP, will be favorably affected. The USPSTF has taken an important step in securing access to services that will hasten the end of the HIV epidemic in the United States by 2030.”
This development is yet another welcome one in the continuing efforts to ensure that PrEP is made available to all. Last month, it was announced that a generic form of Truvada will come out in 2020. Truvada is the only drug approved by the Food and Drug Administration to be sold as PrEP, and cost nearly $3000 per month. A generic version could drastically lower the price.
Last month also saw the announcement of a partnership between the Centers for Disease Control and Prevention (CDC) and the pharmaceutical company Gilead that involves Gilead donating 2.4 million bottles of Truvada to the CDC over the next 11 years.