HIV prevention is a serious health concern for the U.S. Pre-exposure prophylaxis or “PrEP” is a daily pill that can prevent HIV transmission and has helped the U.S. curb HIV infections nationwide. While the launch of PrEP has been radical in the fight against HIV, the cost structure for PrEP is facilitated by unstable legislation, called the 340B Drug Pricing Program. This instability is posing the U.S. to waste healthcare dollars, burden the HIV workforce, and keep high-cost drugs in the market so qualified entities, like STD clinics, can accumulate enough savings to keep the lights on.
Why is this happening? First, it is important to understand that the Public Health Service Act includes the 340B Drug Pricing Program which requires pharmaceutical manufacturers who participate in Medicaid to provide discounts on drugs to qualified organizations that see a high volume of uninsured and low-income patients. HIV/AIDS community centers and STD clinics make up many of these qualified organizations and are caught in the middle of helping prevent HIV with use of the affordable PrEP and generating their own savings if they push more expensive alternative medications like Truvada or Descovy, which can cost nearly $1,800 per month compared to a generic PrEP like TDF/FTC which can cost as little as $30 per month.
These 340B savings are not necessarily a bad thing for clinics because they need the funding to stay open. But, pushing high-cost drugs for savings creates tension in the health care system with other programs, like Medicaid and Medicare, whose drug pricing can’t always be offset by discounts or copay assistance programs.
What can be done about this? In simple terms, legislators need to find alternatives to the 340B program to create funding for HIV and STD clinics in the U.S. Making the savings they use to keep their facilities functional contingent on high-cost medication will always cause these qualified entities to push more expensive drugs instead of their effective generic alternatives. The system will remain broken as long as funding is based on drug discounts and the 340B Program must be reevaluated and reconsidered to discourage a waste of dollars in the healthcare system and a better outlook for the prevention of serious diseases like HIV.
To discuss more on HIV medications, government funded drug programs, or anything you've read about in this article, please reach out to the Arxcel team; we're happy to help.