Prime supports initiative to end the HIV epidemic by 2030

According to the Centers for Disease Control & Prevention (CDC), at year-end 2019 an estimated 1.2 million people in the United States aged 13 and older had HIV in the U.S. and an estimated 13% of those people didn’t know they had the virus.¹ Government agencies are rallying around initiatives such as Ending the HIV Epidemic in the U.S. (EHE) with the goal of reducing the number of new HIV infections by 90% in the United States by 2030.²

Awareness and prevention prior to exposure are integral in reducing the number of people affected by HIV. In part to support this initiative, the United States Preventive Services Task Force (USPSTF) released an Affordable Care Act (ACA) guideline recommending pre-exposure prophylaxis (PrEP) at no cost to anyone at risk of HIV acquisition.³

To align with this initiative, in July 2020, Prime and its Blue Plan clients introduced ACA HIV PrEP benefits that increased access to PrEP antiretroviral medicines for at-risk people. The updated benefit design leveraged claims data to give doctors and their non-HIV infected patients $0 access to PrEP medications while minimizing disruption in therapy and promoting adherence for members already taking the same medicines for HIV post-exposure prophylaxis or treatment in accordance with their benefits.

Prime also has a number of pharmacy network initiatives, including specific HIV and quality of care networks and maintains contracts with many HIV pharmacies to ensure patient access and support their care needs. Patients are able to use any HIV focused pharmacy or other pharmacies of their choice as part of their benefit.

Prime and its Blue Plan clients are committed to helping in the goal to reduce the incidence of HIV infection.

Overview of Market and Prime Therapeutics’ HIV Spending

*blended PrEP + PEP (Post-Exposure Prophylaxis) + treatment & $0 member spend from ACA or client programs

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1. https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics
2. https://www.cdc.gov/hiv/policies/strategic-priorities/mobilizing/prevention-priorities.html
3. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/prevention-of-human-immunodeficiency-virus-hiv-infection-pre-exposure-prophylaxis