ADAP Advocacy has taken a stand against the inclusion of HIV antiretroviral therapies in the Medicare Drug Price Negotiation Program, citing potential risks to individuals living with HIV/AIDS. The organization's public comments to the Centers for Medicare and Medicaid Services highlight the critical need for a carve-out to protect these life-saving medications. Brandon M. Macsata, CEO of ADAP Advocacy, emphasized the dangers of disrupting access to HIV treatments, which could lead to treatment discontinuation, increased mortality from opportunistic infections, and the development of drug-resistant HIV strains.
The advocacy group's stance is rooted in the 'treatment as prevention' strategy, a key component in the fight against HIV that not only improves individual health outcomes but also reduces the spread of the virus and associated healthcare costs. ADAP Advocacy's concerns are detailed in their written testimony to CMS, which argues for the preservation of access to HIV medications amidst ongoing drug price negotiations. The full testimony can be accessed for further insight into the proposed HIV carve-out and its implications for public health at https://www.adapadvocacy.org/cms-testimony.
This opposition comes as Medicare prepares to negotiate drug prices for the first time under the Inflation Reduction Act, a program intended to lower costs for beneficiaries and reduce federal spending. ADAP Advocacy argues that while cost containment is important, it must not come at the expense of vulnerable populations who depend on consistent access to specific medications. The organization points to the unique nature of HIV treatment regimens, which often require precise combinations of antiretroviral drugs tailored to individual patients' viral loads and resistance profiles.
Disruptions to these regimens could have severe public health consequences beyond individual patient harm. The development of drug-resistant HIV strains could undermine decades of progress in HIV treatment and prevention, potentially leading to broader community transmission of resistant viruses. ADAP Advocacy's position reflects concerns that price negotiations might limit formulary options or create barriers to accessing newer, more effective treatments as they become available.
The organization's testimony emphasizes that any savings achieved through price negotiations on HIV medications could be offset by increased healthcare costs resulting from treatment failures, hospitalizations, and new infections. This perspective highlights the tension between immediate cost containment goals and long-term public health investments in disease management and prevention. The outcome of this debate will have significant implications for approximately 1.2 million people living with HIV in the United States, particularly those aged 65 and older or with disabilities who rely on Medicare for coverage.
