The Department of Health and Human Services (HHS) will utilize donated HIV prevention drugs and drugstore services to provide individuals who lack prescription drug coverage access to free PrEP, the agency announced on December 3.
The program, branded as “Ready, Set, PrEP,” provides those who test negative for HIV and have a prescription PrEP but do not have prescription drug coverage the ability to receive free HIV prevention medication donated by Gilead to the federal government as part of a deal struck in September to provide enough of the medication to cover up to 200,000 people annually for up to 11 years. Under the program, Rite Aid, Walgreen’s, and CVS Health are donating dispensing services beginning in May of next year.
Gilead has not relieved the government of all costs involved in the program, however. HHS will shell out $200 per bottle to Gilead for the costs of transporting the drugs to patients. That will last until March, then the government will turn to drug stores for dispensing services and counseling and search for cheaper ways way to move the medication from Gilead to those drug stores, according to The New York Times.
HHS did not directly answer questions about the program’s long-term fate, but when referring to the services donated by the drug stores, HHS told Gay City News “those donations will take effect no later than the end of the current Gilead Distribution Agreement, which is March 30, 2020. The agreement lasts for a year with an option to renew by agreement of the parties.”
HHS did not return subsequent emails seeking clarification about whether that agreement referenced by HHS involves only the drug stores or if Gilead’s donations also last for a year with options to renew.
The long-term viability of the plan is further complicated by the government’s lawsuit targeting Gilead for copyright infringement and the administration’s search for cheaper ways to distribute the drugs.
In a press release announcing the news, HHS described the program as a “key component” of the federal government’s plan to end the epidemic and says it will help save lives.
“Thanks to Ready, Set, PrEP, thousands of Americans who are at risk for HIV will now be able to protect themselves and their communities,” HHS Secretary Alex Azar — previously a pharma executive with Eli Lilly and Company — said in a written statement.
While “Ready, Set, PrEP” only covers a slice of those who could benefit from free PrEP, the stipulations attached to the program could limit the pool of potential benefactors. There are individuals with insurance plans that officially cover prescription drugs but either charge unaffordable co-pays for medication or force folks to pay out of pocket until they spend thousands of dollars to reach a high deductible before more reasonable prescription costs kick in. Those individuals would be disqualified from participating in the program due to their health insurance coverage, but still struggle to afford steep prices for PrEP medication.
The requirement of a prescription also comes with potential barriers for individuals who, due to lack of insurance, are not able to cough up hundreds of dollars to pay for doctor visits necessary to obtain a prescription. Participants in the HHS program must also cover their lab work in recommended quarterly doctor visits while on PrEP.
Advocates voiced skepticism following the government’s announcement. The PrEP4All Collaboration, which is a coalition of advocates calling for PrEP accessibility, did not respond to requests for comment. But James Krellenstein, a co-founder for PrEP4All, tweeted, “If the $6 million taxpayers are paying @GileadSciences to distribute their ‘donation’ was instead used to pay for lab work and clinical visits for PrEP patients, we could get 6,000 more people on PrEP.”
Jason Rosenberg, an activist involved with ACT UP New York, tore into the program, ripping Gilead for profiting on the taxpayers’ dime and blasting the Trump administration for only providing assistance to 200,000 uninsured people.
“This is a band-aid to systemic greed of pharmaceutical companies,” he said in a tweet on December 4. “We need to deploy a universal HIV program that ensures free HIV meds and PrEP for everyone — not just 200,000. Fuck this PR stunt.”
Amid widespread criticism over the high price of medication, patent violation allegations, and Gilead’s use of taxpayer dollars to fund its own research to produce expensive drugs, the pharma giant caved to pressure in May and announced it would release its patent on Truvada for PrEP next year. That announcement was met with disapproval from advocates who said that development needed to come sooner.
In the meantime, some US states have taken action aimed at increasing access to PrEP. Governor Andrew Cuomo of New York in July outlined requirements for insurers abiding by state regulation to provide PrEP and HIV screenings without charging out-of-pocket costs. Those plans include Obamacare and employer-sponsored group policies, but the benefit does not extend to those with corporate self-funded plans and out-of-state plans.
California’s State Legislature has also pushed back against barriers to PrEP by launching a legislative effort to offer HIV prevention drugs without a prescription. That measure was passed and signed into law by Governor Gavin Newsom in October.
Learn more details about the Ready, Set, PrEP program, including eligibility details, at GetYourPrEP.com or call 855-447-8410.
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