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Kamala Harris hopes to make insurance companies cover PrEP at no out-of-pocket cost to patients

Published on 25/06/19 at 09:30am
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Democratic presidential candidate Kamala Harris has introduced a bill which would require all private and public insurance plans to cover the cost of preventative HIV drug PrEP and all related services at no out of pocket cost for patients.

The introduction of the bill comes after the United States Preventative Task Force issued a grade A recommendation for PrEP which means private insurance companies will have to cover the cost of the drug by 2021.

The grade A recommendation also follows Gilead Sciences announcement that a generic version of PrEP drug Truvada would come to market a year early in 2020, as the firm agreed to donate 11 years’ worth of the drug for 200,000 people. Gilead’s drug currently costs $1675 a month or $20,000 a year. The costs associated with follow up visits and lab testing are also a deterrent for those who may benefit from PrEP.

“PrEP is a critical advancement in the first against HIV that can finally provide peace of mind to Americans who live in the shadow of the HIV epidemic. But for too many in our country, lack of insurance coverage and steep costs have put PrEP out of reach—and that needs to change,” Harris said in a statement.

“We must truly commit ourselves to HIV prevention by finally requiring every health insurance plan—public and private—to cover PrEP and all of the required tests and follow-up doctors’ visits. We must also provide the resources necessary to help people without insurance access PrEP. Nearly four decades since the beginning of the HIV/AIDS crisis that took so many lives and caused countless others to live in fear, we can and will stop the spread of this disease.”

While ensuring both public and private health insurance plans cover the cost of PrEP, Harris’ bill would also make the drug available to the uninsured through a funded grant programme aimed at assisting states, territories, and tribal communities in increasing access to PrEP.

The bill would also stop insurance companies from denying coverage or charging higher premiums for those who take PrEP.

“We cannot end the HIV epidemic without dramatically scaling up access to PrEP. This bill includes a comprehensive and unprecedented set of non-discrimination and access protections aimed at tackling the formidable stigma, coverage, and cost barriers to PrEP.  Funding for a national PrEP program—that includes resources to support medication, labs, and clinical services—is also critically necessary to scale up PrEP in communities disproportionately impacted by HIV,” said Amy Killelea, JD, Senior Director, Health Systems Integration, National Alliance of State and Territorial AIDS Directors.

Louis Goss

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