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The second-largest insurer in the United States, Aetna, has agreed to lower the costs of pharmaceutical drugs to people living with HIV/AIDS after legal action by the AIDS Institute (TAI) and The National Health Law Program (NHeLP).
NHeLP and TAI filed a complaint in May 2014 with the U.S. Department of Health and Human Services Office for Civil Rights, charging four Florida health plans, including Aetna, with unlawful discrimination against people living with HIV and AIDS.
Aetna announced on March 26th that HIV medications would be moved to a generic brand tier in all of its plans. This will lower co-payments, which were recently $1,000 a month for some medications, to a range of $5-$100, after deductibles. These reductions will be effective June 1, 2015.
Elizabeth G. Taylor, NHeLP’s executive director, said, “We are pleased that Aetna is taking the right steps. Our complaint cited these barriers to accessing prescription drugs, and we are glad to see developments to remove them.”
Statistics from the Centers for Disease Control and Prevention (CDC) show that more than 1.2 million people are living with HIV infections in the United States. Many of these are living healthy lives as a result of anti-retroviral therapy. Adherence to such antiretroviral therapies is critical to long-term survival. Two factors pose a challenge to the affordability of these courses of treatment according to the Fair Pricing Coalition, a group of activists who advocate regarding the price of HIV and hepatitis drugs.
One is the high cost of the drugs themselves. A spokesperson from the Coalition says “High drug prices [are] being set and increased annually by manufacturers.” They quote as an example one of the least expensive U.S. Department of Health and Human Services (HHS) preferred drug combinations for HIV, Atripila. The current estimated publicly available price is $24,026 per year. This reflects a 6.6 percent increase over the 2013 price and a 12.3 percent increase over the 2012 price. Another regimen, Stribild, entered the market in 2012 with an annual price of $28,500, which increased by 4.9 percent in January 2014. For comparison, the Consumer Price Index (CPI), a measure of U.S. inflation, rose only 1.4 percent in 2013. The medical CPI for 2013 was 2.5 percent.
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