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Sign on by March 31, 2021 (12:00 Noon EST) to support access to PrEP and PEP.
March 22, 2021
The Honorable Xavier Becerra United States Secretary of Health and Human Services Hubert H. Humphrey Building 200 Independence Avenue, SW Washington, D.C. 20201RE: Access and Uptake Challenges to Pre and Post-Exposure Prophylaxis (PREP & PEP)
As community-based service organizations and LGBTQ+ organizations representing HIV care providers, advocates, and people living with or at risk-of transmission or acquisition of HIV, we are determined to meet the goals outlined in the Ending the HIV Epidemic initiative. Aligned to that work are opportunities for building better access and utilization of HIV preventative measures, such as Pre and Post-Exposure Prophylaxis (PrEP & PEP).
As you are aware, the U.S. Preventive Services Task Force (USPSTF) issued (June 2019) the recommendation that—at its core—intends on expanding accessibility to PrEP. Under the USPTF recommendation, all non-grandfathered private health plans—including individual, small group, large group, and self-insured plans—are required to cover PrEP without cost-sharing, beginning no later than the 2021 plan year; whereas cost-sharing also includes zero co-pays and zero co-insurance. But to date, that work—of stopping onward HIV transmission with the expansion of PrEP and PEP—remains largely underutilized.
And while there are a variety of underutilization issues the community is working to address, we are writing you today to express our growing concern that public and private payors are continuing to take both active and unnecessarily restrictive measures that limit access to all FDA-approved forms of PrEP and PEP. And as advocates and at-risk community members, we’re calling on health plans and payors to eliminate all barriers to PrEP and PEP access—including those forms of utilization management that further restrict ancillary services related to each.
Taken regularly, PrEP reduces the risk of contracting HIV through sex by as much as 99%. PEP, too, is equally effective when taken within 72 hours of an exposure to HIV. In fact, there are multiple forms of PrEP that are both clinically-efficacious and available, and there are additional options in the pipeline, including long-acting injectables. Determining which one is the most clinically-appropriate is a conversation that should remain between a patient and their provider. Fundamentally, this is a patient protection and health equity issue rather than a cost-affordability issue alone, if we are committed to ending the HIV epidemic.
This is particularly true for underserved populations, and for racial and ethnic minorities that are disproportionately impacted by HIV and COVID-19. And whether individuals are enrolled in Medicare or Medicaid; are insured via Affordable Care Act (marketplace) plans; or receive coverage through commercial and employer-sponsored plans, it’s vital that all their subscribers have full and open access to both PrEP and PEP without restrictive protocols.
Sincerely,
"list in formation"
HealthHIV The National Coalition for LGBT HealthAdd your signature here.
For more information, contact Scott Bertani, Director of Advocacy, scottb@healthhiv.org.
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