Story at a glance
- More than 50 members of Congress have signed a letter to the Centers for Disease Control and Prevention and the Centers for Medicare and Medicaid Service asking the agencies to make a new injectable treatment for HIV prevention free for patients.
- Apretude, the first injectable treatment for HIV-1 PrEP, was approved by the Food and Drug Administration in December.
- While current PrEP treatments are available at no cost to patients, they are difficult to keep up with and access is limited in communities of color.
Nearly 60 members of Congress are calling on the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare and Medicaid Services to require insurance providers to cover a cutting edge HIV prevention drug at no cost to patients.
The letter, dated Feb. 4, was written by Democratic Reps. Ritchie Torres and Mondaire Jones, both representing New York and the first openly gay, Black members of Congress. It was signed by 56 other House Democrats.
The letter calls for full coverage of Apretude, the first injectable treatment for HIV preexposure prophylaxis (PrEP) that was in December approved by the Food and Drug Administration (FDA). Unlike other PrEP treatments, which are typically once-daily oral medications, Apretude requires only a bimonthly injection to prevent HIV infection.
“By making PrEP easier for patients than ever before, Apretude can play a critical role in preventing new HIV infections — enabling millions of Americans to live free from fear of HIV. To ensure that this life-saving medication is as accessible as possible to the people who need it most, particularly LGBTQ+ people and people of color, we urge you to ensure that public and private insurance plans cover Apretude at no cost to patients — just like the other forms of PrEP,” Torres and Jones write in the letter.
The Centers for Medicare and Medicaid Services over the summer announced that nearly all health insurers would be required to cover PrEP with no cost sharing, including for clinic visits and lab tests.
PrEP treatments have been essential in combating the spread of HIV, a sexually transmitted infection that attacks the body’s immune system. Transmission can also occur through contact with infected blood, such as by sharing needles or syringes.
When taken properly, PrEP is 99 percent effective against sexually transmitted HIV infections, according to the CDC, and increased use of PrEP contributed to an 8 percent decline in new HIV infections between 2015 and 2019, the agency has estimated.
But as Torres and Jones note in their letter, currently available PrEP treatments can be difficult to keep up with, as patients, along with remembering to take a pill every single day, also have to take quarterly blood tests and attend multiple follow-up appointments with doctors to screen for HIV infection.
“These burdens are a major reason why far fewer people take PrEP than could benefit from the treatment, and why many of the people who do use PrEP struggle with it. Multiple medical, social, and socioeconomic factors make it challenging for many people to meet these demands, including poverty, mental health conditions, challenges with substance use, social pressure to conceal the medication, and simple forgetfulness,” Torres and Jones wrote.
Access to traditional PrEP treatments is also limited among communities of color and transgender women, reflecting the higher rates of HIV infection within those groups.
According to the FDA, cisgender men and transgender women who have sex with men were 69 percent less likely to become infected with HIV while taking Apretude than while taking oral PrEP. Cisgender women were 90 percent less likely to become infected.
Currently, with insurers not required to cover all costs for the drug, Apretude has a list price of $3,700 per dose, NBC News reported.
“Our health care system must not financially discriminate against what may be the most effective way of preventing this harrowing epidemic. Insurance plans should provide Apretude on those same terms: cost-free. We also urge you to use every tool at your disposal to make all forms of PrEP, including Apretude, free to everyone who needs them, regardless of insurance status,” Torres and Jones write in their letter.
“Only by making Apretude free can we fulfill its promise to liberate millions of people, particularly LGBTQ+ people and people of color, from the risk of HIV infection.”
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