HIV

Aetna Inc. has agreed to reduce out-of-pocket payments for most HIV and AIDS medicines after pressure from an advocacy group, revising coverage that had some patients paying $1000 a month for the drugs.

Modeling data discussed at a press conference at the 2015 Conference on Retroviruses and Opportunistic Infections showed that delaying HCV treatment, consequent to the high cost of the newer antiviral regimens, could prove fatal in patients coninfected with HIV.

Although one of the central features of the Affordable Care Act was eliminating discrimination based on preexisting conditions, there is evidence insurers have found ways to dissuade high-cost patients from enrolling in their plans.

The plaintiff, John Doe, alleges that not having access to a community pharmacist will limit his ability to gain counseling on potential drug interactions. United Healthcare settled a similar action earlier in 2014. Consumer groups have also alleged discrimination against HIV patients by insurers over drug access in Florida.

The FDA will recommend in 2015 to lift the lifetime ban on blood donations from gay and bisexual men. However, the agency will keep in place a one-year ban after homosexual activity.

On World AIDS Day, advocates mark "the beginning of the end" of the pandemic. In the United States, 2014 has been marked by battles between patient advocacy groups and some payers over the price of generic HIV drugs on exchanges under the Affordable Care Act.

An investigation into 2012 Medicare claims for HIV-infected patients unearthed payment for prescriptions that were filled up to 32 days after the patient's passing.

Researchers at the George Washington University (GW) were awarded a grant estimated to be funded at $23.8 million from the Centers for Medicare & Medicaid Services (CMS) to study a new model that aims to improve HIV prevention and care while lowering healthcare costs.

Triumeq(R), the first-ever single pill triple drug combination against HIV, was approved absed on the results of 2 clinical trials.

Older patients who are diagnosed with HIV/AIDS present a variety of challenges for providers, especially when it comes to controlling their costs of care.

HIV-positive individuals are not usually enrolled in clinical trials, resulting in a knowledge-gap on their treatment options.

Dr. Michael Bell, previously announced as the keynote speaker for the September 25-26 live meeting hosted by The American Journal of Managed Care, this weekend discussed his role in overhauling lab safety at the Centers for Disease Control and Prevention in Atlanta. Attendees at AJMCLive's Atlanta conference, "Value-Based Decision-Making in Infectious Disease," will have the chance to hear Dr. Bell discuss the prevention of hospital-acquired infections.

However, a point to note is that this was a small cohort study without a comparator arm.

The Affordable Care Act (ACA) prohibits insurance companies from rejecting new customers based on their pre-existing health conditions. Yet, a recent report alleged that 4 Florida-based payers may have structured their prescription drug benefit plans in a way which does just that.

The American Journal of Managed Care will host a two-day event September 25-26, 2014, in Atlanta taking on some of healthcare's biggest challenges in infectious disease, including HIV, MERS and how to pay for new therapies for hepatitis C. Giving the keynote address will be Michael Bell, MD, deputy director of the Centers for Disease Control and Prevention's Division of Healthcare Quality Promotion.

The American Journal of Managed Care will host a two-day event September 25-26, 2014, to take on some of healthcare's biggest challenges: Treatments that cure hepatitis C are making news but upending balance sheets. A recent recommendation seeks preventive therapy to stop new cases of HIV. Hospitals and public health officials are grappling with how to prevent the spread of MERS. Only AJMC will bring payers, clinicians, policy leaders, and pharmaceutical representatives together to share ideas.

David Alain Wohl, MD, associate professor, division of infectious diseases, University of North Carolina at Chapel Hill, suggests that quality management of HIV has, for the most part, been self-regulated. He says that when it comes to HIV management, there is a lack of feedback or "quality improvement mechanisms" outside the managed care setting.

Evidence-Based Immunology and Infectious Disease, the fourth title in the news series from The American Journal of Managed Care, launches with an issue that features interviews with leading AIDS researchers, a discussion of the challenges of paying for breakthrough therapies for hepatitis C, and new information on causes and treatments for rheumatoid arthritis.