PBM Reform: The Challenges of PrEP Access
Carl Schmid, executive director of the HIV+Hepatitis Policy Institute in Washington, D.C., talks about the problems associated with generic HIV PrEP drug markups and potential ways to fix it.
The FTC recently released their second report on PBMs about price hikes on the list price generic drugs and held a virtual meeting where they accepted comments from the public.
Carl Schmid, Executive Director, HIV+Hepatitis Policy Institute, Washington, D.C., spoke about copay accumulator programs and why they must stop. He sat down with Managed Healthcare Executive afterward and explained how HIV medications are involved and why cost sharing is supposed to be free for specific forms of PrEP - but isn’t.
“We're still finding that, despite the ACA requirements that preventive drugs such as PrEP should be free, both for drugs and for the ancillary services, around one-third of all people are being charged and cost sharing and it's a real deterrent to people,” Schmid said in an interview with Managed Healthcare Executive. “One of the problems is that the providers don't know the billing codes, and then [insurance companies] just deny.”
Lenacapavir HIV PrEP: Not an AIDS Vaccine, but Vaccine Adjacent
June 19th 2025Experts and advocates say that twice-a-year HIV PrEP injections have the prevention potential of a vaccine — and that a once-a-year version of lenacapavir would be even better. But will Yeztugo be available to the people who would benefit most from HIV PrEP?
Read More
Trump Budget Axes CDC HIV Prevention, Shifts Care, Experts Warn of Risks
June 10th 2025Although some HIV programs will remain, the proposed cuts in the fiscal year 2026 budget are too severe and will hinder HIV care and research in the United States, according to Carl Schmid, executive director of the HIV+Hepatitis Policy Institute in Washington, D.C.
Read More
