From Evidence to Implementation: Clarifications Around USPSTF Recommendations for HIV Pre-Exposure Prophylaxis (PrEP) - Episode 16

Overcoming HIV PrEP Access Barriers With Advocacy Groups

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Carl Schmid shares insight on the use of advocacy groups to help patients overcome barriers to access for HIV PrEP therapy.

Ryan Haumschild, PharmD, MS, MBA: Before we conclude, I do want to transition to advocacy, because that’s another important segment of PrEP [pre-exposure prophylaxis]. And just overall, and Carl, back to you, this is probably one of the main advocates we have in the space and representing many advocacy groups. What barriers are these advocacy groups helping to overcome that we’ve spoken about throughout this peer exchange? And what are some of the future strategies that advocacy groups are focusing on to continue to support access, especially building off the opportunities that Sean eloquently mentioned earlier?

Carl Schmid: I’m proud of the work that the advocacy community has done to get to where we are today. It’s because of our work is that we got the U.S. Preventive Services Task Force grade. It’s because of our work we got the guidance coming out of HHS [Department of Health and Human Services] that all plans have to cover the ancillary services as well. And when we saw problems with plans, we publicized it, and we went to the media. And hopefully, that forced or encouraged payors to change some of their practices. And now we’re listening to people’s complaints. And we also have alerted all the insurance commissioners about this requirement in working with them. It’s also part of the national HIV/AIDS strategy. We have a strategy to end HIV in the United States by 2030. In PrEP and prevention of HIV is a significant component. It’s the main reasons why we can end HIV. For the future, I feel that we’re at the beginning stages of PrEP still. What we’ve done right now is fine. We have a great system called the Ryan White Care program [Ryan White HIV/AIDS Program] for people living with HIV. But we don’t have a system for people who are at risk of HIV. And we’re working with members of Congress. Some bills have been recently introduced to establish a national PrEP program to pay for the drug and the ancillary services for the uninsured and the underinsured. But also, to put grants out around the country to work on provider outreach to work on community education. Because there’s still a lot of work to be done. And this establishes programs throughout the country where they’re needed to increase PrEP. Those are the things that we’re working on right now to help increase the uptake of PrEP.

Ryan Haumschild, PharmD, MS, MBA: I’m excited about the future because it sounds like we have some strategies and there’s still a lot to be done. And it’s great, like you said, advocacy. I loved how you said to encourage payors because it’s a collaborative approach. And Ryan knows that. And that’s what makes us so successful. Sometimes we’ve got to have that prompting to keep moving forward. I want to thank you all, every single one of you for this rich and informative discussion peer exchange. Sometimes this is some of the best information that all payors, providers, and pharmacies look to when they’re trying to consider some of these topics like PrEP therapy. And having experts here to share your discussion on these really relevant topics, policy, and FAQs [frequently asked questions], helps provide people the context, and the thoughts that we have moving forward in the space.

Transcript Edited for Clarity