The number of individuals living with HIV who receive their health insurance from Medicare almost tripled from 1997 to 2014, with about 120,000 HIV-positive Americans now dependent on the program. This means about one quarter of all
While the ability to access prescription drug coverage alone is a major necessity for all patients, within the Part D program is a clause known as the six protected classes that is especially important to those living with HIV. Under this clause, providers are required to cover "all or substantially all" medications that fall within the six protected classes of medicine. These classes include vital drugs that treat mental illness, cancer, organ transplant and of course, HIV.
Several months ago, the administration proposed changes to Part D that would allow plans to institute prior authorization and coverage exemptions of antiretroviral medications that treat HIV. Changing the protected class status for antiretrovirals could undermine the substantial progress we have made in HIV care over the past two decades. Not only could this lead to delays, disruptions and discontinuations in access to treatment, but it could also increase transmission to others.
Fortunately, public outcry from the LGBTQ community, patient advocacy groups and health care stakeholders has pushed the
The medical community has made great strides in the treatment of HIV and other serious illnesses through the access and affordability that Medicare Part D provides, as well as the
That is an unacceptable reality. The important role HIV medications play in helping patients live and thrive as they age, as well as its importance in preventing new infections, demonstrates the need for policies that protect access to these crucial antiretroviral medications and foster new medical discoveries. As
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