The financial burden on insured patients receiving the HIV-preventative PrEP (pre-exposure prophylaxis) has been greatly reduced due to a recently-announced Biden Administration mandate requiring health insurance companies to stop charging co-pays and deductibles related to the drug. The mandate also applies to related blood work and office visits.
“This is great news and a game-changer in preventing new HIV infections for at-risk individuals and individuals with lower income and/or no access to medical care,” Matrix Community Health Services Outreach Manager Royale Theus told Pride Source. “By removing this financial burden, it will allow countless at-risk individuals the opportunity to prevent HIV infection by taking PrEP.”
Drake Collins, a prevention specialist with Corktown Health, agreed.
“This is everything we have been hoping for in the PrEP navigation program,” Collins said. “It’s a real game-changer.”
For too long, cost has been a barrier for many individuals interested in taking PrEP, Collins said.
“I have worked with people here at Corktown who stopped taking PrEP as a result of these additional costs. With this new guidance, the financial barrier is removed.”
Currently, there are two approved forms of PrEP, Truvada and Descovy. Both should now be completely free to individuals with insurance, thanks to the guidance from the Centers for Medicare and Medicaid Services, the Department of Labor and the Department of the Treasury.
“This will primarily help people who have private insurance, who could sometimes have very high co-payments, and hopefully it will help motivate others to consider taking PrEP,” said Collins.
For those without any form of insurance, however, the news is not as promising.
“We’re facing a crisis among people who are often poor and uninsured who have decreasing options to get PrEP care covered,” said Kenyon Farrow, managing director of the national organization Prep4All, in a statement posted to the group’s Facebook page.
“We are calling on the Federal government to look for ways to cover people who are uninsured, particularly in non-Medicaid Expansion states to be able to access PrEP services,” the statement read. “If we’re serious about ending the HIV epidemic, we have to ensure equal access to PrEP in all communities, and not only for the insured.”