The drug, Truvada PrEP, is more than 95 percent effective in preventing the contraction of HIV, which can result in AIDS. It’s typically prescribed to HIV-negative gay men and those at high risk of infection.
“If everyone took PrEP, there would be no more HIV. It’s that potent, that strong,” Dr. Scott Parry with Intown Primary Care, one of the top providers of PrEP, told WSB-TV.
The issue came to light when a website, The Body, reported that the former employee was denied coverage. Since 2015, Fulton County Board of Public Health’s HIV prevention program has prescribed Truvada for PrEP 255 times, said Dr. David Holland, chief clinical officer for communicable diseases for the program. Holland confirmed to AP that the former Publix employee, a Georgia resident, had been denied coverage — the only such case he'd seen.
Publix did not respond to the Associated Press’s calls and messages last week.
Human rights groups spoke out against the chain, calling its denial for PrEP insurance coverage discriminatory.
“It is not a stretch of the imagination to think that this could actually be a discriminatory practice that targets members of the LBGT community for their sexuality,” Jeff Graham with Georgia Equality told Channel 2.
However, following a meeting with Publix officials to address the issue, Florida state Rep. Carlos Guillermo Smith, D-Orlando, an openly gay legislator, took to Twitter Monday to detail how the talks went. He wrote that company officials confirmed the decision to deny coverage but wouldn’t say if it “was based solely on cost or some absurd moral objection they have to PrEP.”
Publix responded early Tuesday, and said it had reconsidered its decision and would cover the drug. “We regularly evaluate what is covered by our health plan and have made the decision to expand our health plan’s coverage of Truvada to include Pre-exposure Prophylaxis (PrEP),” the company tweeted. “We are working with our pharmacy benefits manager to implement this change.”
"I think they know and understand that this is the right thing to do for their employees," Smith said.
According to HIV specialists and gay rights groups, the drug is almost universally covered by large employers who provide prescription drug coverage for their workers. Gilead Sciences, its manufacturer, estimated U.S. usage at 120,000 people last year.
The average lifetime cost of treating a person who becomes HIV positive at 35 is $449,000, and that doesn’t include treating anyone else the person might infect, according to Atlanta-based Centers for Disease Control and Prevention.
"Whether or not it is illegal, it is misguided from both a health perspective and an economic perspective,” Scott Schoettes, HIV project director at gay rights organization Lambda Legal, said. “You don't have to be a rocket scientist to know that it is better and cheaper if someone isn't infected.”