Image credit: Tony Webster
A huge change happened for customers of health insurer UnitedHealthcare yesterday, Sept. 1, as the insurer requires its policy holders to switch to Truvada as they are no longer covering payments for the pre-exposure prophylaxis (PrEP) drug Descovy.
MedCity News reports that people on Descovy would have to talk to their doctors to either switch them to using branded Truvada or its generic version that is meant to arrive on the market by Sept. 30. People taking Descovy who intend to continue doing so will have to pay higher and acquire a prior authorization.
UnitedHealthcare policy holders who decide to go with the generic version of Truvada instead will be able to acquire it with no out-of-pocket cost.
The move by the insurer could have widespread effects on people on PrEP. While Truvada and Descovy are both made by pharmaceutical company Gilead Sciences and have the same effectiveness, Descovy has fewer side effects than Truvada. Compared to Truvada, users of Descovy suffer less incidents of kidney function loss and do not lose as much of their bone mineral density.
Gilead said that a decision like the one UnitedHealthcare made could “further complicate an individual’s decision to use PrEP and jeopardize ongoing efforts to curb new HIV infections and end the epidemic.”
However, MedCity News quotes University of Michigan’s Center for Value-Based Insurance Design director Dr. Mark Frederick as saying that the decision might actually convince more people to go on PrEP as there will be no cost-sharing should they decide to use the generic version of Truvada.
According to Frederick, offering more people a lower-cost drug at zero cost sharing is a trade-off that he would be willing to make, especially if he were a government body like the New York City health department.