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Scott Saloway, NPR and Ryan Benk, NPR

July 29, 2021 12:12 PM

The federal government is making HIV prevention treatment free — but there's a catch

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Truvada, one of the medications authorized for PrEP, recently went generic. PrEP is now required to be covered by insurance providers. — Truvada, one of the medications authorized for PrEP, recently went generic. PrEP is now required to be covered by insurance providers.
Jeff Chiu/AP

The federal government is making it much easier for Americans to get their hands on a potentially life saving treatment, if you have health insurance.

It's called PrEP, a once-daily pill that is 99 percent effective at preventing HIV infections.

PrEP has been around for nearly a decade, and health officials have long advocated for high risk people to take it, but usage has been limited due to the costs. Truvada, one of the medications authorized for PrEP, recently went generic, but used to cost upwards of $1,800 a month. The doctor's visits and lab tests can cost hundreds more.

"You have to go to the doctor basically four times a year, at least per CDC guidelines, and get a checkup to make sure that you don't have HIV and that everything else kind of looks OK," James Krellenstein of the advocacy group PrEP4All told NPR's Steve Inskeep. "A lot of health insurance wouldn't cover it. People would be stuck [paying for] laboratory bills and clinic visits."

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Recent federal guidance says health insurance companies must cover all of the costs for the treatment, including the medication, doctor's visits, and lab tests.

Krellenstein says for those who have health insurance, this removes a major barrier to getting on PrEP. But for those without insurance, issues remain.

"We don't have universal health insurance in the United States," Krellenstein said. "So the real challenge today, the next challenge in prep access, is going to figure out what policies the CDC and the Department of Health and Human Services can put into place to ensure that those people can also access PrEP as easily as people with insurance."

The CDC tells NPR it is working on "multiple fronts" to ensure access to PrEP — including "focused funding to help deliver" the treatment to those who need it the most.

Listen to Krellenstein's full Morning Edition interview.

This story originally appeared on the Morning Edition live blog.

Copyright 2021 NPR. To see more, visit https://www.npr.org.