Wiener will hold an oversight hearing on Kaiser’s recent policy change to classify HIV medication as specialty drugs, which dramatically increases the cost of these drugs by requiring patients to pay a significant percentage of the drug cost instead of a copay
San Francisco – Today, Supervisor Scott Wiener issued the following statement on Kaiser Permanente’s recent action to dramatically increase the cost of HIV drugs for patients:
“This new policy by Kaiser is troubling because it dramatically increases the cost of HIV medication, which will reduce access to HIV medication at a time when we are working hard to increase access and improve community health. This cost increase for HIV-positive Kaiser members will be a burden that some patients won’t be able to bear. I will be meeting with representatives from Kaiser and calling for an oversight hearing at the Board of Supervisors to address this decision and its impact on the health of our city’s residents, as well as to explore solutions that will reverse this trend toward more expensive HIV medication.”
According to a report published in the Bay Area Reporter, Kaiser Permanente recently began requiring people living with HIV/AIDS to pay a percentage of the cost their drugs, instead of a copay amount. Last year, the copay amounts for generic drugs was $35, and the copay for brand name drugs was $50. While these copays remain for most drugs, Kaiser created a tier of drugs called “specialty drugs” where patients also pay 20% of the cost of those drugs. This is part of a growing trend for insurance companies to move certain drugs, including HIV drugs, to a specialty tier. The result is that patients may have to pay hundreds of dollars a month for their HIV medication.
Access to HIV medication is a core part of San Francisco’s “Getting to Zero” strategy – zero new infections, zero HIV deaths, and zero stigma. Access to HIV medication for HIV-positive people is critical because that access keeps these patients healthy and suppresses their viral load. People with suppressed viral loads are much less likely to transmit the virus to other people.
Supervisor Wiener will hold the oversight hearing within the next month at a Board of Supervisors committee.