TALLAHASSEE, Fla. – Florida Insurance Commissioner Kevin M. McCarty announced today that parent company, Aetna is revising its HIV/AIDS drug formulary for both on and off exchange individual health plan products for the following subsidiary companies: Aetna Health Inc., Aetna Life Insurance Company, Coventry Health Care of Florida, Inc. and Coventry Health Plan of FL, Inc. The new change means a majority of HIV/AIDS drugs currently labeled as specialty drugs in the highest cost tier of the drug formulary are being reclassified as either generic or non-preferred brand drugs and moved into the lower cost tiers.
Effective June 1, 2015, individuals covered by these Aetna plans will be able to purchase all non-invasive, oral HIV/AIDS drugs as generic or non-preferred brands, resulting in reduced costs and better access to these important medications. This coverage will also extend to individual health plan members in 2016. Group products issued by these companies and which do not already contain this formulary coverage are being evaluated for similar changes.
“The action taken by Aetna to better serve Floridians with HIV/AIDS demonstrates a high level of commitment and responsiveness to the needs of their customers,” stated Commissioner McCarty. “I am pleased to report this good news and look forward to working with other health plans who have also committed to focusing their efforts on this important issue."
Last year, the Office was made aware that several health plans may have been violating Florida’s HIV/AIDS anti-discrimination law. The Office conducted an in-depth review of the allegations, met with the health plans and reached an agreement to revise the drug formulary and certain treatment protocols on an interim basis. The health plans agreed to implement short-term measures to limit cost-sharing responsibility for HIV/AIDS drugs in the highest tier of their drug formularies, to eliminate prior authorizations or step therapy for such prescribed medications or treatments, and to look for long-term solutions that would better address the affordability and accessibility of HIV/AIDS medications for Floridians.