CMS proposes coverage for pre-exposure prophylaxis regimens to prevent HIV
The Centers for Medicare and Medicaid Services on Wednesday proposed coverage for pre-exposure prophylaxis (PrEP) using antiretroviral therapy to prevent HIV infections.
The news comes nearly six months after CMS initiated a national coverage analysis for PrEP. Medicare coverage for PrEP currently varies by plan, though many patients are left with high out-of-pocket costs. According to one 2020 study that analyzed a variety of Medicare plans in the Ann Arbor, MI area, the average annual cost for someone with a prescription drug plan was between $2,276 and $2,430, including deductibles, monthly premiums, copays and coinsurance.
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