Is Insurance a Barrier to HIV Preexposure Prophylaxis? Clarifying the Issue
Is Insurance a Barrier to HIV Preexposure Prophylaxis? Clarifying the Issue
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DOI：
10.2105/ajph.2019.305389
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发表时间：
2020-01-01
影响因子：
12.7
通讯作者：
Pinto, Rogerio M.
中科院分区：
文献类型：
--
作者：
Kay, Emma Sophia;Pinto, Rogerio M.
临床试验表明，暴露前预防（PrEP）可以预防艾滋病毒感染；然而,尽管食品和药物管理局(FDA)批准,在2012年,只有不到10%的符合条件的用户在美国目前采取PrEP.While影响准备吸收,有多种因素构成壁垒准备实现,这里我们重点准备的成本在美国,,目前每月2000美元的标价和高水平的成本分摊,可以把保险用户提供超过1000美元每年需要支付的费用。我们讨论了患者的免赔额、每月保费、共付额和共同保险如何差异很大，并可能增加经济负担。尽管药物支付援助计划使没有保险和保险不足的使用者更负担得起PrEP，但缺乏保险是获得PrEP的一个障碍。FDA于2017年批准了一种通用版本；然而，该版本尚未分发给美国消费者，可能不会更实惠。随着其他国家开始实施PrEP规划，PrEP作为全球抗击艾滋病毒工具的可用程度仍有待观察。
Clinical trials have demonstrated that preexposure prophylaxis (PrEP) protects against HIV infection; yet, even with its approval by the Food and Drug Administration (FDA) in 2012, less than 10% of eligible users in the United States are currently taking PrEP.While there are multiple factors that influence PrEP uptake and pose barriers to PrEP implementation, here we focus on PrEP's cost in the United States, which, at the current list price of $2000 per month and with high levels of cost sharing, can leave insured users with more than $1000 in out-of-pocket costs every year. We discuss how patient deductibles, monthly premiums, copayments, and coinsurance vary widely and may increase the financial burden. Although drug payment-assistance programs have made PrEP more affordable to uninsured and underinsured users, lack of insurance is a barrier to PrEP accessibility. The FDA approved a generic version in 2017; however, that version has not been distributed to US consumers and may not be more affordable.As other countries begin implementing PrEP programs, the extent of PrEP's availability as a tool in the global fight against HIV remains to be seen.