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Fourth Florida Insurer Agrees To Cap Cost Of HIV Drugs

The last of four Florida insurers for the high cost of their HIV drugs relented last week, saying it would cap what patients pay every month for four types of medication.

鈥淲e will voluntarily agree to set an out-of-pocket limitation of $200 per month on each of the following drugs: Atripla, Complera, Stribild, and Fuzeon,鈥 Preferred Medical Plan CEO Tamara Meyerson wrote to Kevin McCarty, commissioner of the Florida Office of Insurance Regulation, in a Jan. 14 .

The other three companies 鈥 , and 鈥 had earlier reached formal agreements with state regulators to lower their prices and to fill prescriptions without prior authorization for 2015.

Preferred did not violate Florida鈥檚 anti-discrimination laws, said Amy Bogner, a spokeswoman for the state鈥檚 insurance office.

An estimated 120,000 Floridians have HIV, and nearly half of them live in South Florida, according to .

The four Florida insurers were the focus of a federal civil rights complaint filed last May by , a nonprofit group in Tampa. The complaint accused insurers of discriminating against people with HIV by making their medications too expensive 鈥 as much as $1,500 per month for drugs on some health plans offered in Florida last year.

The U.S. Department of Health and Human Services is still investigating the complaint, according to spokeswoman Rachel Seeger.

Carl Schmid, deputy executive director of The AIDS Institute, said he was disappointed the state did not ask Preferred to sign a more extensive agreement.

鈥淲hat鈥檚 in the letter is really nominal,鈥 Schmid said. 鈥淚t doesn鈥檛 even say how long Preferred has to abide by these terms.鈥

But David Poole, a spokesman for the , which worked with state regulators on the drug pricing issue, called the letter 鈥渁cceptable鈥 and said all insurers should ensure antiretroviral medications are 鈥渁ccessible and not economically out of reach.鈥

The news comes as Gov. Rick Scott confirmed that he was McCarty, who has led Florida鈥檚 insurance regulator since 2003.

AHF yesterday sent a to the governor praising McCarty鈥檚 work on the pricing of HIV drugs.

鈥淭he actions of the commissioner and his staff assured 鈥 that public health in Florida would not suffer because of the restrictive actions the private insurance companies had instituted,鈥 the letter said.

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