A class of drugs that prevents the spread of HIV, HIV testing and clinic visits must be provided cost-free to patients from most health insurance plans, a new federal regulation requires, NBC News reports.
So called pre-exposure prophylaxis, or PrEP medications, known by brand names Truvada or Descovy, reduce the transmission of the virus that causes Acquired Immune Deficiency Syndrome, or AIDS. People who contract HIV and AIDS have drug, treatment and testing costs significantly higher than the cost of the PrEP drugs. Taken daily, the PrEP drugs cut the risk of HIV infection by 99%.
The Centers for Medicare and Medicaid Services, along with the Department of Labor and the Department of the Treasury, sent directions to health insurers Monday indicating that insurers have 60 days to comply with the mandate concerning their plan design and must have all people prescribed the drug covered by January 1, 2022.
Prices for a generic version of Truvada under the name emtricitabine/tenofovir disoproxil fumarate, which came on the market earlier this year, is just $30 per month, but the non-generic version of Truvada is $1,842. Descovy’s list price is $1,930.
“Now it is important that people who are eligible for PrEP, along with their providers, are aware of these new requirements,” Carl Schmid, executive director of the HIV+Hepatitis Policy Institute said of the new guidance to insurers regarding PrEP-related cost sharing. “We also have to hold insurers accountable to ensure they are doing their job in complying with their legal obligations. Plan reviews still show many insurers are not in compliance, and we need state insurance regulators to enforce the law and the new guidance.”