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.”
