UPDATE: HIV meds to remain on preferred status with Medicaid

UPDATE 4:55 p.m.: All single-pill HIV regimens will remain on preferred status with Medicaid. Commissioner Reece's office confirms that the DCH website will be updated to reflect this update. Here's the blow-by-blow per Dr. Melanie Thompson, principal researcher with the AIDS Research Consortium of Atlanta in a statement issued to Georgia Voice:

"We received an official email today from the Department of Community Health, Division of Medicaid, confirming that the single tablet regimens Triumeq, Stribild, and Complera will remain on preferred status, along with Atripla. This is the result of very productive – and intensive – discussions between the Division of Medicaid and the HIV community. When I became aware of the issue and approached Dr. Linda Wiant, Chief of the Division of Medicaid, and Dr. Robertson-Jones, the DCH Interim Pharmacy Director, they were very receptive to meeting with us to discuss the issue. 

On August 17 Dr. Wendy Armstrong, Medical Director of the Grady Infectious Disease Program, and Dr. Pat O'Neal, DPH Director of Health Protection, and I met with 7 DCH representatives to present the current DHHS Antiretroviral Guidelines and about 100 pages of data supporting the use of the drugs, as well as analyses supporting the benefits of lower pill burden and single tablet regimens on both health outcomes and cost containment. We also learned that Medicaid has had difficulty getting the pharmaceutical companies to 'come to the table' to discuss costs. We immediately began to work with both Gilead and ViiV to ask them to meet with DCH. We reached out to colleagues at organizations with national scope and our case was bolstered by letters from the HIV Medicine Association (HIVMA), Treatment Action Group (TAG), and Project Inform. Georgia Equality has been a very active partner and delivered a sign on letter with over 400 signatures to the Division of Medicaid. In addition, both the Commissioner of DCH and the Division of Medicaid received numerous other letters supporting our position, including those from Rep. State Sen. Vincent Fort, and the Emory Center for AIDS Research. 

So, this has been a true collaboration involving local and national HIV experts, community advocates, and government. Most importantly, we have forged a very productive relationship with the Division of Medicaid. Dr. Wiant has agreed to have the Division advise on our Fulton County Task Force on HIV/AIDS, and to continue to work with us on other issues such as analyzing Medicaid data to better understand how we can better serve persons with HIV who are cared for in the Medicaid system."

ORIGINAL STORY: 

A Georgia state senator and several LGBT rights groups are calling on the Georgia Department of Community Health (DCH) to reconsider a proposed move that would downgrade several HIV medications from preferred status on its Medicaid formulary. The change would leave only one single-pill daily HIV medication, Atripla, under preferred status, although patients currently taking the other once-daily regiments would be grandfathered in.

State Sen. Vincent Fort (D-Atlanta) sent a letter to DCH Commissioner Clyde Reese on Aug. 15 voicing his objections to the change, citing several statistics on HIV/AIDS medications and saying, “I urge you to reconsider your proposal for the sake of public health. This change could prove to be disastrous and could set our state back in the fight against HIV/AIDS.”

We reached out to Commissioner Reese's office for comment on the matter but they have not been able to confirm receipt of Sen. Fort's letter, a point that drew his ire.

"It's quite telling that Commissioner Reese's office is not acknowledging having received my letter,” he told Georgia Voice Tuesday morning. “I hope it's not an indication of how they're approaching the issue. That tells me it's not a top priority." 

Several LGBT rights and HIV/AIDS groups across the state sent a letter to the DCH on Aug. 24, saying in part about the proposed move, “It will deprive people living with HIV/AIDS in our state of therapies that are otherwise recommended throughout the U.S.”

The groups signing onto the letter were as follows:

SisterLove
Georgia Equality
Georgians for a Healthy Future
The Health Initiative
Positive Impact Health Centers
HIV Dent
Transgender Individuals Living Their Truth
Georgia Watch
Ryan White Program, Fulton County
Advocates for Responsible Care (ArxC)
Specialiy Tiers Coalition of Georgia
Advantage Consulting, LLC
Open Hand Atlanta
Health Students Taking Action Together