• Hypertrophic Cardiomyopathy (HCM)
  • Vaccines: 2023 Year in Review
  • Eyecare
  • Urothelial Carcinoma
  • Women's Health
  • Hemophilia
  • Heart Failure
  • Vaccines
  • Neonatal Care
  • NSCLC
  • Type II Inflammation
  • Substance Use Disorder
  • Gene Therapy
  • Lung Cancer
  • Spinal Muscular Atrophy
  • HIV
  • Post-Acute Care
  • Liver Disease
  • Biologics
  • Asthma
  • Atrial Fibrillation
  • RSV
  • COVID-19
  • Cardiovascular Diseases
  • Prescription Digital Therapeutics
  • Reproductive Health
  • The Improving Patient Access Podcast
  • Blood Cancer
  • Ulcerative Colitis
  • Respiratory Conditions
  • Multiple Sclerosis
  • Digital Health
  • Population Health
  • Sleep Disorders
  • Biosimilars
  • Plaque Psoriasis
  • Leukemia and Lymphoma
  • Oncology
  • Pediatrics
  • Urology
  • Obstetrics-Gynecology & Women's Health
  • Opioids
  • Solid Tumors
  • Autoimmune Diseases
  • Dermatology
  • Diabetes
  • Mental Health

US Preventive Services Task Force’s Recommendation for PrEP

Video

Carl Schmid explains the implications of PrEP therapies receiving a Grade A recommendation from the US Preventive Services Task Force.

Carl Schmid: Having a Grade A recommendation from the United States Preventive Services Task Force for PrEP [pre-exposure prophylaxis] is amazing news. It puts the moniker or seal of approval that this is a preventive service that all providers should follow. It also says that because of the Affordable Care Act and its focus on preventive services, all insurers have to cover PrEP. On top of that, they have to cover it with no cost-sharing for patients. This is extremely important. The federal government has also come out with guidance saying that it’s not only free for the drug, that all the laboratory services and medical visits are free as well. It’s very much like a colonoscopy. You don’t pay anything for the colonoscopy. But what about the anesthesia? What about the removal of the polyp? What about the office visit? There’s no cost-sharing. The federal government has interpreted the Affordable Care Act and the same is true for PrEP and all the associated PrEP services.

This is a game-changer. It should make it more available. Providers should be offering PrEP to every patient who’s sexually active, and at least discussing it with them. Even though we have this in place, it’s not always a reality. We’re still seeing insurers not putting at least 1 PrEP drug without cost-sharing on their formularies. We’re also hearing a lot of cases of insurers still charging their patients for the drug or the laboratory services and medical visits. We need the payers to be compliant with this legal requirement. We’re also calling on the state insurance commissioners to make sure that the plans in their states are in compliance as well. It’s great news. Unfortunately, it’s only covering the oral drugs, but the United States Preventive Services Task Force is also undertaking a review of the long-acting drug. Hopefully that will be covered without cost-sharing in the future as well.

This transcript has been edited for clarity.

Related Videos
Video 11 - "Closing Current Gaps within Fertility Benefits and Care"
Video 10 - "Shaping Fertility Coverage: Access, Costs & Medical Needs"
Video 9 - "Denial of Coverage in Fertility Care"
Video 8 - "Risks of Miscarriage and Multiple Births Associated with Fertility Care"
Video 7 - "Fertility Preservation: Egg Freezing Versus Embryo Freezing"
Video 6 - "Family Building Costs, Barriers, and Dropout Rates Associated with Fertility Care"
Video 5 - "Closing Payer Gaps and Improving Fertility Care Access"
Video 4 - "Increasing Employer Coverage and Maximizing Fertility Benefits "
Video 5 - "Relevance of NUTURE Study Findings for Patients, Payers, Providers"
Video 3 - "Improving IVF Success Rates & Utilizing AI in Fertility Health Care"
© 2024 MJH Life Sciences

All rights reserved.