Dive Brief:
- Aetna has confirmed that beginning June 1, it is moving HIV drugs down from its priciest category of cost sharing, which required members to pay up to half the cost of these expensive drugs, running some members as much as $1,000 per month.
- Following allegations of discrimination from advocates, Aetna is putting the drugs in a category that will run patients between $5 and $100 after their deductibles are met.
- Coventry has announced a similar move, and Humana is reportedly "in the process of developing options to address the high cost of certain specialty drugs" though it hasn't specified details.
Dive Insight:
The moves come following a 2014 complaint filed by the AIDS Institute and the National Health Law Program arguing that Aetna, Humana and Cigna were attempting to push HIV and AIDS patients away from health plans being offered in the federal exchange in Florida by limiting coverage of HIV drugs.
As Bloomberg Business notes, the ACA bars insurers from denying coverage to people who are sick, and advocates for those with expensive conditions have voiced concern that as a workaround, insurers might create plans aimed at discouraging sick people from selecting their coverage.
Carl Schmid of the AIDS Institute told Bloomberg the group would keep pushing insurers to lower costs for HIV/AIDS treatment, and that the group is also targeting prices for hepatitis C drugs.