Reports have emerged of patients being unable to afford the regular lab tests and doctor visits that are required when taking medication that prevents HIV transmission. These costs can be insurmountable even if a patient is receiving assistance from the medication’s manufacturer to receive the medication for free. This can make it difficult for patients to stay adherent to the medication, which could slow attempts to eradicate HIV. Just last month, the U.S. Preventative Services Task Force recommended for physicians to offer pre-exposure prophylaxis to people at high risk of contracting HIV, which will require most health plans to cover the medication by 2021. This will also prevent health plans from charging patients for the medication. However, health plans will still be able to charge patients for the ancillary services associated with taking the medication, like lab tests that can cost hundreds of dollars per month. Additionally, health plans may still limit access to the medication by imposing prior authorization, which would limit the situations where the medication can be prescribed. For example, an insurer could require a provider to prove that a patient is HIV-negative before a prescription will be covered. While this may sound like a simple step, barriers like these can deter patients from accessing medications that they need because they add unnecessary delays to the process.
Last Updated on May 14, 2020 by Aimed Alliance
