Kaiser announced today that it will be reversing a recent policy change to reclassify HIV medication as “specialty drugs,” which dramatically raised costs for patients
San Francisco, CA – Today, Supervisor Wiener issued the following statement on Kaiser Permanente’s reversal of its decision to dramatically increase the cost of HIV drugs for patients, and its return to the previous system where patients pay a low, affordable co-pay for HIV medication:
“Over the course of the last week, I expressed serious concern to Kaiser about this policy change that would have dramatically affected access to care for HIV-positive patients. Throughout the week, I heard an outpouring of concern from the community about the effects of these cost increases. Yesterday at a meeting in my office, Kaiser informed me that these cost increases will no longer be taking place, and that patients will be returned to the previous system of paying manageable co-pays for these life dependent medications. Kaiser also informed me that it will be reimbursing patients for any increased co-payments that patients made. I want to thank Kaiser for its recognition of the dramatic impact these drug cost increases would have had on patients, and for taking swift action to ensure the health of people living with HIV.”
Last week, after learning of these cost increases. Supervisor Wiener announced he would be calling for an oversight hearing on the drug cost increases and working with Kaiser to find solutions to reverse the trend of increasing drug costs.
According to a report published in the Bay Area Reporter, Kaiser began requiring people living with HIV/AIDS to pay a significant percentage of the cost HIV medication, instead of a fixed co-pay 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 total price of the 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 – even as high as $600 or $900 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.