In recognition of World AIDS Day, which was observed on December 1, Sentry takes a look at the evolution of HIV medication, treatment, and how the 340B Drug Pricing Program can help. The theme for the 2019 observance is, “Ending the HIV/AIDS Epidemic: Community by Community.” World AIDS Day was first observed in 1988.
Since the early 1980s, HIV and AIDS have been a mystery to healthcare providers everywhere. First, the question was what caused it. Once researchers solved that part of the mystery, the industry moved on to the next big question: How do we cure it?
And there’s no doubt that we’ve made progress since those early days. In March of this year, scientists announced that, for only the second time since the global epidemic began, a patient appears to have been cured of HIV infection. This breakthrough occurred when a patient was given a bone-marrow transplant as part of cancer treatment, The New York Times reported. But as the article notes, “Bone-marrow transplantation is unlikely to be a realistic treatment option in the near future. Powerful drugs are now available to control HIV infection, while the transplants are risky, with harsh side effects that can last for years.”
In further advancements, a monthly HIV injection is scheduled to become available in early 2020. It combines two drugs: the integrase inhibitor cabotegravir and the NNRTI rilpivirine.
Where does 340B come in?
It’s the cost of HIV drugs that brings 340B into the equation. One form of preventive care that has been proven effective for HIV is a once-daily pre-exposure prophylaxis (PrEP) oral medication. However, as NPR notes, the price of PrEP is about $1,600 per month, and the CDC says that only about 10 percent of the 1.2 million people who would benefit from PrEP are currently on the treatment.
During the State of the Union in February of this year, the President shared the administration’s goal to “eliminate the HIV epidemic in the United States within 10 years” and “defeat AIDS in America.” Shortly thereafter, the administration released a plan with more details and steps needed to achieve this goal. The plan includes reducing the number of new HIV infections in the United States by 75 percent within five years.
“HHS expects most new patients receiving care through the initiative will be uninsured … the administration wants to utilize 340B discounts so more patients can obtain HIV preventive care from Ryan White HIV/AIDS Clinics (RWCs) and federally qualified health centers (FQHCs),” reports 340B Health. “We are very cognizant about the price of PrEP,” Brett Giroir, MD, HHS Assistant Secretary for Health, said. “We intend to use the 340B program, which allows PrEP to be obtained at a much lower cost to the government.” This goal aligns with Congress’s original intent for the 340B program – to enable covered entities to stretch scarce federal resources.
Keeping Ryan White clinics open across the country
Covered entities that are eligible for the 340B program include, but are not limited to, hospitals that are disproportionate share, critical access, sole community, rural referral centers, some children’s and cancer centers, federally qualified health centers, and Ryan White Comprehensive AIDS Resources Emergency (CARE) Act clinics and programs. Because the program is intended to help covered entities support more comprehensive services for vulnerable patients, which may include access to affordable medications, HIV clinics and associated high-cost HIV medications are a natural fit.
“It is not an easy thing for a Ryan White clinic or community health center to serve the needs of all their clients who are living with or affected by HIV,” according to a blog post from AIDS United. “In fact, in the current political climate where receiving level funding year after year is often the best-case scenario, providing the extensive amount of care required is often impossible. That most Ryan White clinics and community health centers have been able to survive and even expand during these lean budgetary times is remarkable. In many cases, such success has only been achievable through the utilization of the 340B Drug Pricing program.”
Sentry continues to support its covered entity customers in their efforts to serve patients with HIV/AIDS as well as other vulnerable populations across the country. We unite with communities around the world in efforts to end the HIV epidemic, learn how to prevent HIV, support people with HIV, and remember those who have lost their lives to AIDS.