AHF: FL Insurance Commissioner McCarty Announces Improved Nationwide Access to HIV Medications
March 26 2015 - 6:50PM
Business Wire
Florida Insurance Commissioner Kevin M. McCarty announced this
week that Aetna, Inc. and Coventry Health Care of Florida, Inc. are
revising their HIV/AIDS drug formularies for individual health plan
members. The new change means a majority of HIV drugs currently
labeled as specialty drugs in the highest cost tier of the drug
formulary are being reclassified as either generic or non-preferred
brand drugs and moved into the lower cost tiers.
Effective June 1, 2015, individual health plan members of these
two insurers will be able to purchase oral HIV drugs as generic or
non-preferred brands, resulting in reduced costs and better access
to these important medications. This coverage will also extend to
individual health plan members in 2016 and extend geographically
throughout the United States, and not just in Florida, according to
sources contacted at Aetna.
“It is great to see that the results of months of dialogue and
advocacy among key stakeholders throughout the U.S. have yielded
such positive results with an impact that could ultimately be far
more significant if adopted throughout the industry,” said AIDS
Healthcare Foundation Southern Bureau Chief Michael Kahane.
The stakeholders involved in these negotiations included AIDS
Institute, NHeLP, AIDS Foundation of Chicago, and AIDS Healthcare
Foundation (AHF).
“Aetna and Coventry’s actions represent a high level of
commitment and responsiveness to the needs of its members,” stated
Commissioner McCarty. “I look forward to working with the
other health insurance companies who have also committed to
focusing their efforts on this important issue.”
“It is also important to note that Aetna/Coventry’s change from
the specialty tier for these important life-saving drugs will
provide more choice for the patients in that they will have the
option to visit a brick and mortar pharmacy or can choose to
receive their medication through mail order,” said AHF Southern
Bureau Director of Legislative Affairs David Poole. “We hope
this decision will become a trend in the industry.”
Last year, the Florida Office of Insurance Regulation became
aware of allegations that several health insurance companies may
have been violating Florida law by placing all HIV/AIDS medications
in the highest tier of their drug formulary. The Office performed
an in-depth review of the allegations, met with the health
insurance companies and reached agreements on this issue. The
insurance companies agreed to implement interim measures to limit
health plan members’ cost-sharing responsibility for HIV/AIDS drugs
in the highest tier of their drug formularies; ensure prior
authorizations or step therapy were not required for prescribed
HIV/AIDs drug treatments; and look for long-term solutions that
would better address the affordability and accessibility of
HIV/AIDS medications.
About AIDS Healthcare
Foundation
AIDS Healthcare Foundation (AHF), the largest global AIDS
organization, currently provides medical care and/or services to
more than 362,000 individuals in 36 countries worldwide in the US,
Africa, Latin America/Caribbean, the Asia/Pacific Region and
Eastern Europe. To learn more about AHF, please visit our website:
www.aidshealth.org, find us on Facebook:
www.facebook.com/aidshealth and follow us on Twitter:
@aidshealthcare.
AHFGed KensleaSenior Director,
Communications+1-323-308-1833 work+1-323-791-5526
mobilegedk@aidshealth.orgorChristopher JohnsonAssociate
Director of Communications+1-323-960-4846
work+1-310-886-9913 mobilechristopher.johnson@aidshealth.org