AHCCCS to Begin Covering Pre-Exposure Prophylaxis for HIV

Last month the United States Preventive Services Task Force (USPSTF) listed Preexposure Prophylaxis for the Prevention of HIV Infection (PrEP) as a Category A Preventive Health Service.  That’s an important designation because it means that PrEP will now be included (at no cost to consumers) in all Qualified Health Plans during the next contract year. The final recommendation statement can also be found in the June 11 issue of JAMA.

The task force found convincing evidence that PrEP is of substantial benefit in decreasing the risk of HIV infection in persons at high risk of HIV acquisition.  They conclude that PrEP is associated with small harms, including kidney and gastrointestinal adverse effects and that (with high certainty) the benefit of PrEP (with oral tenofovir disoproxil fumarate–based therapy) is substantial.

Pre-exposure prophylaxis (or PrEP) lowers the chances of getting infected with HIV even if the person otherwise engages in risky sexual behavior.  PrEP can stop HIV from taking hold and spreading through the body and is highly effective for preventing HIV if used as prescribed (but it is much less effective when not taken consistently).  Daily PrEP reduces the risk of getting HIV from sex by more than 90%. Among people who inject drugs, it reduces the risk by more than 70%.

This week AHCCCS announced that they’ll be covering PrEP medications as a benefit for their members beginning on October 1, 2019…  a solid public health move that will lower the transmission of HIV in Arizona. The move will likely produce a positive return on investment also, as preventing HIV is much less expensive than treating persons infected with the virus. PrEP (Truvada) will be on their preferred drug list without Prior Authorization starting 10/1/19.