For Americans who are at high risk of catching the virus that causes AIDS—many of whom are homosexual men—HIV pre-exposure prophylaxis, or Pr EP, is a lifesaver.
The authors of a new study caution that a case that is wending its way through the legal system may drive up the cost of PrEP to levels that many cannot afford, which could result in fatalities. Senior study author Jalpa Doshi, a medical professor at the University of Pennsylvania, stated, “Our findings suggest that out-of-pocket cost increases for Pr EP could upend the progress that has been made towards ending the HIV/AIDS epidemic in the United States.”
The context: People who take either of the two FDA-approved antiretroviral medications (each is actually a two-pill combo) get a highly effective means of preventing HIV infection, even when exposed through sex. The U.S. Centers for Disease Control and Prevention have long contended that access to PrEP is key to ridding the nation of HIV/AIDS.
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However, keeping that access is essential. Insurance companies are not allowed to charge co-pays when members purchase PrEP, according to a 2021 Affordable Care Act rule. But a current legal dispute (Braidwood Management, Inc. v. Becerra) has the potential to undermine that ACA requirement and give insurers the power to require co-pays for PrEP use. How might that impact the medications’ absorption? Doshi and colleagues examined data from an insurer-provided health care database for the years 2016–2018.
More than 58,500 patients had new PrEP prescriptions approved by their insurers. They monitored their records to see how many of those patients stopped taking the medication when their co-pays increased. People started stopping PrEP if their out-of-pocket costs increased, as was to be expected. Even raising co-pays from $0 to $10 doubled patients’ “prescription abandonment” rate, from 5.6% of patients to 11.1%, the researchers found.
If co-pays went even higher—between $101 and $500—more than a third of patients would bail out of the regimen. What might that mean for their health? According to the UPenn news release, people who quit PrEP were “two to three times more likely to get infected with HIV in the following year, compared to those who filled their PrEP prescription.” Doshi and her team believe numbers like that could foretell a rise in HIV/AIDS across the United States and present a real setback to efforts to put an end to the epidemic in this country.
Frequently asked questions
What are the factors that may increase the risk of contracting HIV?
Risk Factors Specific to Adolescents
- Use of alcohol or drugs before sex. This can affect decision-making about whether to engage in sex or to use condoms during sex.
- Not using an HIV prevention method during sex. …
- Sex with multiple partners. …
- Male-male sex. …
- Sharing needles, syringes, or other drug injection equipment.
What are the factors that causes increase of HIV cases?
- The highest risk of getting or transmitting HIV is from sharing needles, syringes, and equipment to inject drugs, hormones, steroids, or silicone. …
- The next greatest risk for HIV infection is from unprotected sexual intercourse (without a condom or medicine to prevent HIV transmission).
How much does it cost to care for HIV patients?
Table 3 presents our estimate of the average lifetime medical cost associated with HIV for an individual living with HIV, which is $420,285 (2019 US$) discounted and $1,079,999 undiscounted. We used a three-year median timeframe from infection to diagnosis and a three percent monthly likelihood of care discontinuation for this base case estimate.
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Disclaimer: The opinions and suggestions expressed in this article are solely those of the individual analysts. These are not the opinions of HNN. For more, please consult with your doctor
