The effective preventive treatment could reduce HIV rates but needs more access and affordability, especially among black and Hispanic populations, researchers say.
Researchers from the Johns Hopkins Bloomberg School of Public Health contributed to a special issue of the Journal of Law, Medicine, and Ethicswhich included studies and commentary supporting a national program to improve access to pre-exposure prophylaxis (PrEP), a drug to help prevent the spread of HIV.
Researchers from Johns Hopkins University, including Bloomberg School, and national HIV policy experts released the policy proposal for the national PrEP program in December 2021.
The proposal outlines a new delivery and financing system that moves away from expensive branded drugs and expands access points to PrEP for individuals who are Medicaid-covered, underinsured and uninsured, underinsured.
“For more than a decade, PrEP has been available as a highly effective tool for curbing the HIV epidemic, but it remains out of reach for many Americans,” Joshua Sharfstein, MD, vice dean of Public Health Practice and Community Engagement and professor of the practice in the Department of Health Policy and Management at Bloomberg School, in a statement.
“This is a matter of equity. Until we address the incredible disparities in income, race and ethnicity, age and place, we will struggle to end the HIV epidemic,” said Sharfstein.
President Joseph R. Biden’s 2023 budget proposal, released in March 2022, includes $9.8 billion in 10-year funding for a national PrEP program.
The academic proposal recommends that the government procure PrEP medication to get a stable supply at a low price. In addition, they recommend clinicians have new options to provide same-day on-site PrEP with improved access to lab testing.
They also recommended that individuals without regular health care should have access to PrEP through community locations, such as domestic violence centers, corner programs and telehealth.
The recommendations, published online on July 29, 2022, also include commentary and research papers addressing key considerations outlined in the policy proposal. The considerations include how to address Medicaid and private insurance coverage for PrEP, increase access for vulnerable communities who need PrEP most, and understand how generic drugs can offset the financial burden.
The results of 1 included study showed that generic drugs offer a promising solution for removing financial barriers to entry. The researchers found that after generic PrEP was introduced to the market, the price per dose of the generic was only $1, compared to $28 for the brand PrEP. However, total PrEP use did not appear to increase during the study period.
Another study in the recommendation showed that the national PrEP program could be modeled on other public health responses, such as the federal Vaccines for Children program, where the government bought vaccines for Medicaid or uninsured children.
Other studies in the proposal include international models of PrEP access, key implementation issues, pathways to increase access to laboratory services for PrEP, potential for public health partnerships, and the role of Medicaid.
Special issue of the journal provides evidence and guidance in support of the national PrEP program to turn the tide against HIV. news item. EurekAlert. July 29, 2022. Accessed August 2, 2022. https://www.eurekalert.org/news-releases/960355