Medicaid should make drugs against HIV to act longer accessible

MedicaID covers around 40% of HIV-elderly adults in the United States. People with HIV represent 1% of beneficiaries and 2% of expenses. However, disparities in access and compliance in our community have led to an increased concentration of HIV transmissions in black, Latin and transgender communities. The Centers for Disease Control recently published an estimate of the use of preparation in 2022 which showed one in four and less than one in five people who should take prep used it.

Prolonged action drugs can be promising for HIV prevention and compliance

Percées in HIV drugs can be essential to stop the transmission and improvement of compliance, according to a policy file entitled The Big Idea by the O’Neill Institute for National and Global Health Law of the Georgetown University Law Center, in partnership with the TAP-IN INDIDA CARE AND CARTELLI project (CAI).

The Big Idea Brief says: “The progress of HIV clinical practices with the development of longer -term products (the) for the treatment and prevention of HIV could be transformers and could lead to more sustainable viral suppression, improved health results and less cases of HIV. However, unless Medicaid programs adapt and respond to these developments, the opportunity they offer. ”

Products with prolonged action can be presented in several forms:

• • DNA flea patch
  • Inject to greater action

• Implant
• Longer action oral pill

How medicaid and states should help

Medicaid’s political decision -makers and state officials do not keep informed of pharmaceutical breakthroughs that may have a positive impact on the lives of HIV patients. The brief recommends that the centers for Medicare & Medicaid Service (CMS) are associated with the Ministry of Health and Social Services and even name a point dedicated to being proactive, in particular with regard to prevention.

According to Jeffrey S. Crowley, director of the Center for HIV and Infectious Disease Policy at the O’Neill Institute: “A few years ago, CMS published advice. A unique diet for people with HIV treatment takes four pills. This is the whole medication in a pill, so it’s a single tablet. “And one of our recommendations in this brief is to say that you have to do the same with the longer term products.”

HIV inequality

Crowley points to greater inequalities surrounding HIV, in particular with regard to black, brown and marginalized communities. “HIV has always been very uneven, and we have great inequalities. But for many people, current treatments, oral pills work well, but not for everyone, “he says. “But I’m talking about prolonged action products because we have injectables now, but we are going to have implants. We are going to have a range of things.”

Ideally, it is a question of determining what will be best for each individual; Some people will never want a photo, and others will not like several pills. “With HIV, there is this reason why you take medication every day, but for preparation, it’s like, I don’t have a disease. Why I take it daily? If you just have it sometimes a year, it could help for membership,” according to Crowley.

“We want a miracle solution, and there is none. “Our challenge is that technology brings us so far that we have to keep people engaged. Who are people including 95% of the population benefit? Who are these 5%, and don’t they need much more support? barriers. So that people can stay engaged in care. »»

The brief offers braided to extend the scope of HIV services.

• Maximize the potential of the Medicaid state
• Draw on health exchanges
• Use the support of the Ryan White AIDS program (and other social determinants of health program support)
• EHE (ending epidemic funding of HIV)

* The O’Neil Institute has independently created the political project in the longer term but received the support of Gilead Sciences, Merck and VIIV Healthcare.