The Affordable Care Act and the Burden of High Cost Sharing and Utilization Management Restrictions on Access to HIV Medications for People Living with HIV/AIDS.

The HIV/AIDS epidemic continues to be a critical public health issue in the United States, where an estimated 1.2 million individuals live with HIV infection. Viral suppression is one of the primary public health goals for People Living with HIV/AIDS (PLWHA). A crucial component of this goal involve...

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Published in:Population Health Management Vol. 19; no. 4; pp. 272 - 279
Main Author: Zamani-Hank, Yasamean
Format: research tables/charts Journal Article
Published: Mary Ann Liebert, Inc. 2016
Online Access:View this record in EBSCOhost
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      pub: Mary Ann Liebert, Inc.
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        atl: The Affordable Care Act and the Burden of High Cost Sharing and Utilization Management Restrictions on Access to HIV Medications for People Living with HIV/AIDS.
      aug:
        au: Zamani-Hank, Yasamean
        affil: Department of Health Behavior & Health Education University of Michigan School of Public Health 1415 Washington Heights Ann Arbor, MI 48109
      sug:
        subj:
          Health Insurance Exchanges
          Literacy
          Drug Labeling
          Patient Protection and Affordable Care Act
          Insurance Carriers
          Quality of Health Care
          Health Services Accessibility
          United States
          Michigan
      ab: The HIV/AIDS epidemic continues to be a critical public health issue in the United States, where an estimated 1.2 million individuals live with HIV infection. Viral suppression is one of the primary public health goals for People Living with HIV/AIDS (PLWHA). A crucial component of this goal involves adequate access to health care, specifically anti-retroviral HIV medications. The enactment of the Affordable Care Act (ACA) in 2010 raised hopes for millions of PLWHA without access to health care coverage. High cost-sharing requirements enacted by health plans place a financial burden on PLWHA who need ongoing access to these lifesaving medications. Plighted with poverty, Detroit, Michigan, is a center of attention for examining the financial burden of HIV medications on PLWHA under the new health plans. From November 2014 to January 2015, monthly out-of-pocket costs and medication utilization requirements for 31 HIV medications were examined for the top 12 insurance carriers offering Qualified Health Plans on Michigan's Health Insurance Marketplace Exchange. The percentage of medications requiring quantity limits and prior authorization were calculated. The average monthly out-of-pocket cost per person ranged from $12 to $614 per medication. Three insurance carriers placed all 31 HIV medications on the highest cost-sharing tier, charging 50% coinsurance. High out-ofpocket costs and medication utilization restrictions discourage PLWHA from enrolling in health plans and threaten interrupted medication adherence, drug resistance, and increased risk of viral transmission. Health plans inflicting high costs and medication restrictions violate provisions of the ACA and undermine health care quality for PLWHA.
      pubtype: Academic Journal
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        tables/charts
        Journal Article
      ougenre: Article
    language: English
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