What We’re Reading: US Tells Insurers to Cover PrEP; Opioid Lawsuit Settlement; NYC Requires COVID-19 Vaccinations

The federal government requires insurers to cover PrEP; Johnson & Johnson (J&J) and pharmaceutical wholesalers agree to settle opioid crisis lawsuits; NYC health care workers will be required to receive a vaccine or weekly tests for COVID-19.

Federal Government Requires Coverage for PrEP

The federal government will require all health insurers to cover both versions of PrEP, Truvada and Descovy, essentially allowing patients to maintain their prescription for the HIV prevention medication without cost sharing. However, NBC News reported that prescribing physicians will be asked to persuade insurers that Descovy is medically necessary for patients for the drug to qualify for $0 cost sharing. Insurers will have 60 days to comply with the mandate and they will not be allowed to charge copays, coinsurance, or deductible payments for the mandated clinic visits and lab tests for maintaining a PrEP prescription. The mandate comes after insurers were required to cease out-of-pocket fees for PrEP on January 1, 2021.

J&J, 3 Wholesalers Settle Opioid Lawsuit

Johnson & Johnson (J&J) along with pharmaceutical wholesalers McKesson, AmerisourceBergen, and Cardinal Health, reached a settlement agreement of $26 billion in a lawsuit accusing the companies of instigating the opioid crisis, according to STAT News. About 3000 lawsuits were filed by states, counties, cities, and tribes claiming that the wholesalers did not appropriately monitor suspicious shipments and that drug makers were accused of downplaying addiction risks for opioid painkillers and encouraged overprescribing of the medications. The wholesalers will pay up to $21 billion over the next 18 years and J&J will pay $9 billion over 9 years and will cease opioid sales. Over 40 states are anticipated to agree to the settlement and have 30 days to sign on to the deal. Local governments have an additional 120 days to sign the deal.

NYC Requires COVID-19 Vaccinations for Health Care Workers

Mayor Bill de Blasio said health care workers in New York City hospitals and health clinics will be required to either get vaccinated or take weekly COVID-19 tests. According to CNN, de Blasio said that he hopes the move will encourage hesitant health care workers to get vaccinated as the city places a larger emphasis on reaching out to vaccine holdouts and the delta variant causes US cases to rise 48% in the last week. The requirement will go into effect on August 2. Workers who refuse both options will be subjected to suspension without pay. The rule will apply to all doctors, nurses, administrative staff, and custodians that work in the city’s public Health + Hospitals health care system, which only has 60% of its staff vaccinated, and the city’s health department.