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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.  


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  1. Friar Chicken

    Considering that I can’t get many medications or treatments I need from my insurer, to have them take on this additional cost to prevent a disease that is already preventable seems wrong. Men just have to stop barebacking, period. It has to be socially unacceptable, and having HIV has to remain socially unacceptable. In fact, men should stop bottoming altogether, except for fingers or dildos. There’s no excuse for the financial drain on society caused by AIDS at this point. I survived the epidemic, as did a lot of guys, because we were sensible. That is part of why we have to define ourselves by who we love, not who we “fuck,” and we have to stop imitating heterosexuals when it comes to fucking. Porn is largely to blame. Bottoming was not so prevalent until after 2000 or so, when porn began to feature it with far more emphasis, with bottoms squealing like girls and acting like it’s the greatest thing in the world. It’s not. Fellatio is better. There are other ways to enjoy a man’s ass. Lick it (carefully), finger it, feel it, frot it, but don’t fuck it.

    • Lamar

      I’m in a 100% agreement, let alone with everyone, one would encounter. And yeah, I’ve often thought of the cost fiscally, must absolutely astronomical. Secondly, where/how hiv came to be in the first place, was of grave concern to me. Just the other day I was talking to someone, he mentioned “prostate massage,” I hadn’t heard that term before, there’s clearly another
      way to experience anal-penetration/entry if you have to go that route.

      Personal responsibility, first and foremost, contributes positively ‘civically’ speaking.

  2. Hunter0500

    Reality check: Insurers pay for (“cover”) nothing. Insureds, through premiums and copays, pay for everything. Insurers get to keep what’s left over. If/when drugs or procedures become covered, premiums are increased to cover their newly added costs. All of which make the Affordable Health Care Act most UNaffordable for those who pay premiums and copays.

  3. Libertarian Queer

    So, what is the advantage for the larger part of the population that doesn’t engage in risky behavior? Is that advantage a larger insurance bill to subsidize yet another rather smallish subset of the population that apparently doesn’t have the mental capacity to to make prudent decisions? Is it to subsidize those who can think only with their dick or ass? Is there nobody out there who realizes that NOTHING is cost free? Do any of you actually think the insurance or drug companies are suddenly going to become angelic benefactors and just absorb the cost of this at the expense of the CEO’s salary, corporate profits, and investor dividends? This is truly bull shit. It doesn’t even begin to address all the other STDs out there. All because some stupid, selfish, idiots won’t use a damned condom or think they are going to find the meaning of life through injecting drugs with dirty needles. I hope they enjoy their eventual debilitation if not demise from tertiary syphillis, herpes encephalitis, drug resistant gonnorhea, cytomegalovirus, and the list goes on and on. But they won’t have to worry about HIV now, will they. And now, I’m expected to subsidize those idiots instead of letting nature take it’s course.

    What a pathetic excuse for a free country the US is becoming with all this socialistic crap infiltrating every goddamn nook and cranny of our existence. One of these days, when our enemies in the world finally figure out the US citizens are nothing more than spineless and brain-dead twits, they will send their soldiers here to destroy, kill, rape, and pillage and the guts and blood of all the US citizens will be lubricant for the tracks of their tanks. No socialist deserves liberty or freedom. Once their masters determine the useful idiots have outlived their usefulness of helping those in power through socialism, those in power will crush them under their heel. It has happened time and time again throughout history yet people never learn their lesson.

  4. Jason W

    Great, yet another reason for insurers to raise rates on everyone because some people just don’t know how to keep it in their pants or just do plain old safe sex…

  5. Lamar

    It’s all about the “nobodies accountable mentality,” this country increasingly seems to be succumbing to. Until you know, whom you’re dealing with and even then, I personally, still do not trust them enough to be exchanging fluids other than saliva. Going to have become more unconventional to quell these burgeoning std’s, sti’s, HIV/aids. Especially here in the southeastern states, for the last two yrs., consecutively, these statistics are growing dramatically.

    I call Ft. Lauderdale ‘bottom-dale,’ my god, man, it’s all about anal-sex, it’s too scary the mindset/s here, good thing the weather here is lovely, though. The men are nice to look at;
    not much else….I’m always down for forms of masturbation its the only thing for sure, that’s safe.

  6. arturo23

    If you needed any more proof that radical activists control science, in addition to government, this recommendation is icing on the cake.

    The same protection that stops venereal disease stops the transmission of HIV. “But condoms chafe my bum”, they are a threat to my freedom, cry the activists. Let’s get the government to force private insurers to cover PREP, so that the costs (thousands of dollars per month) are paid by my co-workers. If you have Medicaid, let’s make the taxpayers pay.

    If I want to drive recklessly, I have to pay extra to insure my car. No smoke detectors, I pay extra to insure my home. Most of you don’t want to pay extra so I can drive my car recklessly, it’s not your role to pay for someone else’s risky behavior. It’s too bad the risk-takers don’t have to bear the costs, they screamed loud enough the government got the USPSTF to bail ’em out. Wait till people realize these meds aren’t without risk, then we’ll pay settlements on top of the costs of these pills. Bah!

  7. MXB26

    What about the rest of us that play safe and want to have that extra layer of protection. Lets face a few hard realities in this world condoms are not fool proof and break. I have seen plenty of articles that cover stealthing (secretly removing a condom during sex) and sabotage where condoms are intentionally compromised prior to or during a sexual encounter. This can be done either through puncturing them with needles in advance or intentionally breaking them during sex – There are plenty of vids on pornhub that demonstrate the latter. If a bottom goes to check for a condom they can still feel the base even though the tip has been broken. It doesn’t matter how safe you play or try to make your sexual encounters thing can happen either through accident or willful intent so why not take every available opportunity to protect yourself if it’s available. You wear a seat belt in car as protection in case something happens not because it’s going to happen. The same can be said of PreP not every that takes it engages in risky behavior but it’s there in case something does happen.

    You would think that insurance companies would be running to cover PreP instead of discriminating against those that use it and trying to find every way to not pay for it. While I don’t have hard numbers I’m sure the cost of Prep and preventing an infection is far less than the cost of treating someone for an incurable illness for the rest of their life. Many people in this thread so far only seem to care about the potential for increased premiums, which I concede would be a negative. However how much are those premiums going to go up with an untold number of new infections requiring lifetime treatment. Just some food for thought

    • tek

      The “cost” of prep being that Truvada is awful for your body, there are countless lawsuits and even this blog has raised that issue before… but “yeah my prep is now covered.” The long term impact of prep on the body is potentially devastating but don’t try to be safer just take a pill.

  8. anonimatovato

    so many complainers here. yes people should practice safer sex especially if you’re over the top sexually active with multiple partners, but what about cases of rape and you got infected that way? prep would be better to be had than nothing in those cases. I still think the costs will still be too high even with the ‘discounts’ they will provide. pharma companies all about the money. that should be the bigger outrage.


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