Increase in Out-of-Pocket Costs Could Increase Abandonment of HIV PrEP Meds

MONDAY, Jan. 8, 2024 (HealthDay News) -- An increase in out-of-pocket costs for HIV preexposure prophylaxis (PrEP) medications could increase abandonment of PrEP, leading to an increase in HIV diagnoses, according to a study published in the January issue of Health Affairs.

Lorraine T. Dean, Sc.D., from Johns Hopkins University in Baltimore, and colleagues estimated the risk-adjusted percentages of patients who abandoned their initial PrEP prescription across six out-of-pocket spending categories in a sample of 58,529 people with a new insurer-approved PrEP prescription. The percentage of patients who would abandon PrEP under hypothetical changes to out-of-pocket spending ranging from $0 to $500 was then simulated.

The researchers found that abandonment rates increased from 5.5 percent at $0 to 42.6 percent at >$500; there was a doubling in abandonment observed with a small increase from $0 to $10. Conversely, a decrease in abandonment rates was seen from 48.0 percent at >$500 to 7.3 percent at $0. Patients who abandoned versus filled PrEP prescriptions had a two to three times higher rate of HIV diagnoses.

"Our findings suggest that out-of-pocket cost increases for PrEP could upend the progress that has been made towards ending the HIV/AIDS epidemic in the United States," senior author Jalpa Doshi, Ph.D., from the University of Pennsylvania in Philadelphia, said in a statement.

Abstract/Full Text