Aetna, other payers lower costs of HIV drugs

After facing harsh scrutiny for placing HIV and AIDS prescription drugs in the highest category of cost sharing, insurers are reducing out-of-pocket costs for these pricey medications, reported Bloomberg.

Aetna announced last week that it will move the drugs into a category that requires patients to pay $5 to $100 after deductibles are met, according to the nonprofit AIDS Institute, noted Bloomberg. Prior to the change, some Aetna members paid $1,000 a month for the drugs. Changes are effective June 1 and will continue nationwide in the individual market through 2016.

"Aetna's announcement will help ensure that people living with HIV/AIDS throughout the country will have greater access to essential medicines at a more affordable cost," Michael Ruppal, executive director of the AIDS Institute, told Bloomberg. "However, there are still many other insurers who are charging patients excessive costs for their HIV medications."

Elsewhere, Aetna-owned CoventryOne Health will follow in the insurer's footsteps to reduce the cost of drugs, reported the Chicago Tribune. Additionally, Coventry will start classifying the drugs as generic or nonpreferred brands. Last summer, the AIDS institute filed a complaint in Florida with the Department of Health and Human Services claiming that Coventry and other insurers violated the Affordable Care Act by requiring steep co-insurance payments for HIV drugs, FierceHealthPayer previously reported.

Following Aetna's announcement, Humana--which also was in deep water last summer for discriminating against members with HIV--said that it was "in the process of developing options to address the high cost of certain specialty drugs," according to the Tribune. But the insurer did not clarify whether the cost of HIV and AIDS drugs would change.

Price discrimination continues to be a problem throughout the industry. A recent report from the New England Journal of Medicine found that one-fourth of insurance plans use adverse tiering; those enrollees pay an average of $4,892 annually, compared to $1,615 for those in non-adverse tiering plans.

For more:
- here's the Bloomberg article
- read the Chicago Tribune piece