Miami-Dade County

Coventry slashes co-pays on all oral HIV drugs

Atripla, a common fixed-dose once-a-day tablet for the treatment of HIV.
Atripla, a common fixed-dose once-a-day tablet for the treatment of HIV. AP

On Friday, Aetna, which owns Coventry Health Care of Florida, announced it would become the second company to offer reduced co-pays on all oral HIV/AIDS medications, following a civil rights complaint filed last year that accused the company and several others of discrimination.

Effective June 1, all nationwide Aetna and Coventry plans will transfer all oral HIV drugs — currently labeled as specialty medications in the highest cost tier — to the lower cost tiers where the prices and co-pays are more affordable, said David Poole, southern bureau director of legislative affairs for the AIDS Healthcare Foundation, a group that has been involved in advocating for the price changes.

Co-pays — the portion of the charge that consumers pay — will now range from $5 to $100, Poole said. Before the recent price cuts by Coventry and other insurance plans, co-pays on some plans could be as high as $1,500.

The change comes after four Florida insurers — Preferred Medical Plan, Humana, Cigna and Coventry — were cited in a civil rights complaint filed by Tampa-based nonprofit The AIDS Institute, alleging that the insurers were discriminating against people with HIV by making their medications too expensive.

The complaint was filed last May and by January Preferred, Cigna and Coventry had reached agreements with state regulators to lower the costs to consumers on the most common drugs to treat HIV — Atripla, Complera and Stribild— and a less common injectable known as Fuzeon.

In December, Humana was the first to lower cost sharing on all HIV medications for Florida plans. That had a domino effect on Aetna and Coventry, whose decision to expand its previous agreement will also give all customers the choice to get their medications at a retail pharmacy rather than through a mail order system, Poole said.

“Just giving options to these patients to be able to access a brick and mortar pharmacy and not mandating them in the mail order is a big win,” Poole said.

Carl Schmid, deputy executive director of The AIDS Institute, said the Coventry move is significant because it expands on Humana’s plan and brings affordable HIV medications to its plans nationwide.

“This is not just a Florida issue,” Schmid said.

Still, Miami-Dade County has the highest rate of HIV infection cases in Florida, according to state data.

“Aetna and Coventry’s actions represent a high level of commitment and responsiveness to the needs of its members,” Florida Insurance Commissioner Kevin McCarty said in a news release. “I look forward to working with the other health insurance companies who have also committed to focusing their efforts on this important issue.”

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This story was produced in collaboration with Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.

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