Insurer stops covering HIV prevention drug

published on May 6, 2016 by ERIN ELLIS, in Vancouver Sun

Health insurer Pacific Blue Cross is no longer covering a controversial medication that can prevent the spread of HIV, the virus that leads to AIDS.

Letters went out in late April to fewer than 10 people who had been receiving $900 per month in extended health coverage for the once-a-day pill called Truvada, confirmed Joanne Jung, director of pharmacy services for the not-for-profit insurer. The letters said Blue Cross paid for the medication in error and later determined it is not eligible as a pre-exposure prophylaxis or PrEP under the contracts in question.

The drug, which combines two anti-viral agents, was originally developed to treat HIV infections, but was approved by Health Canada in February as a preventive measure when taken by people who do not have HIV but are exposed to it through sex. Some doctors earlier prescribed it for that purpose on an off-label basis.

When used for prevention, Truvada is considered a supplemental drug — as are birth control pills, vaccines, and medications to enhance sexual function — and are not covered under all drug plans, Blue Cross says.

“We sincerely apologize if the letter created any confusion for those members,” Jung added in an emailed statement.

Douglas McClelland, 61, says he took the medication for 18 months, covered by his extended health care plan with Blue Cross, because his partner is HIV positive.

View the full article >>

BC Centre for Excellence in HIV/AIDS

Search form

Insurer stops covering HIV prevention drug

Search form