Watch 02: April 2021

 

The HIV/HCV Co-Infection Watch is a project of the Community Access National Network (CANN) designed to research, monitor and report on HIV and Hepatitis C (HCV) co-infection in the United States. The April 2021 Watch includes timely updates herein. To read the project disclaimer and/or methodology, CLICK HERE.

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1. FINDINGS

The following is a summary of the key findings for April 2021:

AIDS Drug Assistance Programs:

There are 56 State and Territorial AIDS Drug Assistance Programs (ADAPs) in the United States, 47 of which offer some form of coverage for Hepatitis C (HCV) treatment. Of those programs, 44 have expanded their HCV coverage to include the Direct-Acting Antiviral (DAA) regimens that serve as the current Standard of Care (SOC) for Hepatitis C treatment. Three (3) programs offer only Basic Coverage and 9 programs offer No Coverage. One (1) program covers only a single Direct-Acting Antiviral. Three (3) territories – American Samoa, Marshall Islands, and Northern Mariana Islands – are not accounted for in this data. A state-by-state Drug Formulary breakdown of coverage is included in the April 2021 Updates, with accompanying drug-specific maps in Figures 1 – 10.

Medicaid Programs:

There are 59 State and Territorial Medicaid programs in the United States, and data is represented for all fifty (50) states and the District of Columbia. As of October 01, 2016, all 50 states and the District of Columbia offer Expanded Coverage. A state-by-state PDL breakdown of coverage is included in the April 2021 Updates, with accompanying drug-specific maps in Figures 11 – 20.

Harm Reduction Programs:

Every State and Territory in the United States currently provides funding for low-income people living with substance abuse issues to enter state-funded rehabilitation services (National Center for Biotechnology Information, n.d.). Forty-seven (47) States and Territories currently have Syringe Services Programs (SSPs) in place, regardless of the legality. Fifty (50) states and the District of Columbia have expanded access to Naloxone to avert opioid drug overdoses. Fifty (50) states and the District of Columbia have Good Samaritan laws or statutes that provide some level of protection for those rendering emergency services during drug overdoses. Thirty-eight (38) states make reporting to Prescription Drug Monitoring Programs (PDMPs) mandatory, requiring physicians and/or pharmacists to report prescriptions written or filled to a state agency for monitoring. Forty (40) states have Opioid-Specific Doctor Shopping Laws preventing patients from attempting to receive multiple prescriptions from numerous physicians, and/or from withholding information in order to receive prescriptions. Forty (40) states mandate a Physical Exam Requirement in order for patients to receive a prescription for opioid drugs. Twenty-seven (27) states have in place an ID Requirement mandating that people filling opioid prescriptions present a state-issued ID prior to receiving their prescription. Forty-five (45) states require prescribing physicians to attend mandatory and continuing opioid prescribing education sessions. Forty-four (44) states have Medicaid doctor/pharmacy Lock-In programs that require patients to receive prescriptions from a single physician and/or fill prescriptions from a single pharmacy. A state-by-state program breakdown is included in the April 2021 Updates, with accompanying drug-specific maps in Figures 21-29.

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2. AIDS DRUG ASSISTANCE PROGRAMS (ADAPs) & HCV THERAPIES

Of the 56 respective State and Territorial ADAPs, only 9 (ID, KS, KY, OH, UT, VT, GU, PW, VI) do not offer any coverage for HCV drug therapies. States whose formularies are not available on the state-run website have been checked against the most recent National Alliance of State and Territorial AIDS Directors (NASTAD) formulary database (last updated March 24, 2021). The data presented are current as of April 15, 2021.

April 2021 Updates:

Basic Coverage

  • States with Basic HCV Medications Coverage: AL, AK, AZ, AR, CA, CO, CT, DE, FL, GA, HI, IL, IN, IA, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OK, OR, PA, RI, SC, SD, TN, VA, WA, WV, WI, WY, D.C.

  • States without Basic HCV Medications Coverage: ID, KS, KY, OH, TX, UT, VT

  • Territories with Basic HCV Medications Coverage: P.R.

Figure 1. April 2021 ADAP Coverage - Basic HCV Medications Map Key: Yellow = Basic HCV Medication Coverage; Red = No Basic HCV Medication Coverage/No Information regarding Basic HCV Medication Coverage

Figure 1. April 2021 ADAP Coverage - Basic HCV Medications

Map Key: Yellow = Basic HCV Medication Coverage; Red = No Basic HCV Medication Coverage/No Information regarding Basic HCV Medication Coverage

Sovaldi

  • States with Sovaldi Coverage: AZ, CA, CO, GA, HI, IL, IN, IA, LA, ME, MD, MA, MN, NE, NV, NH, NJ, NM, ND, OK, OR, PA, SD, VA, WA, WI, WY, D.C.

  • States without Sovaldi Coverage: AL, AK, AR, CT, DE, FL, ID, KS, KY, MI, MS, MO, MT, NY, NC, OH, RI, SC, TN, TX, UT, VT, WV

  • Territories with Sovaldi Coverage: P.R.

Figure 2. April 2021 ADAP Coverage - Sovaldi Map Key: Yellow = Sovaldi Coverage; Red = No Sovaldi Coverage/No Information regarding Sovaldi Coverage

Figure 2. April 2021 ADAP Coverage - Sovaldi

Map Key: Yellow = Sovaldi Coverage; Red = No Sovaldi Coverage/No Information regarding Sovaldi Coverage

Harvoni

  • States with Harvoni Coverage: AZ, AR, CA, CO, CT, DE, FL, GA, HI, IL, IN, IA, LA, ME, MD, MA, MI, MN, MS, NE, NV, NH, NJ, NM, NC, ND, OK, OR, PA, SD, TN, VA, WA, WI, WY, D.C.

  • States without Harvoni Coverage: AL, AK, ID, KS, KY, MO, MT, NY, OH, RI, SC, TX, UT, VT, WV

  • Territories with Harvoni Coverage: P.R.

Figure 3. April 2021 ADAP Coverage - Harvoni Map Key: Yellow = Harvoni Coverage; Red = No Harvoni Coverage/No Information regarding Harvoni Coverage

Figure 3. April 2021 ADAP Coverage - Harvoni

Map Key: Yellow = Harvoni Coverage; Red = No Harvoni Coverage/No Information regarding Harvoni Coverage

Zepatier

  • States with Zepatier Coverage: AL, AZ, AR, CA, CO, FL, GA, HI, IL, IA, LA, ME, MD, MA, MI, MN, MS, NE, NV, NH, NJ, NM, NY, NC, ND, OR, PA, SD, VA, WA, WV, WI, WY, D.C.

  • States without Zepatier Coverage: AK, CT, DE, ID, IN, KS, KY, MO, MT, OH, OK, RI, SC, TN, TX, UT, VT

  • Territories with Zepatier Coverage: P.R.

Figure 4. April 2021 ADAP Coverage - Zepatier Map Key: Yellow = Zepatier Coverage; Red = No Zepatier Coverage/No Information regarding Zepatier Coverage

Figure 4. April 2021 ADAP Coverage - Zepatier

Map Key: Yellow = Zepatier Coverage; Red = No Zepatier Coverage/No Information regarding Zepatier Coverage

Epclusa

  • States with Epclusa Coverage: AZ, AR, CA, CO, CT, GA, HI, ID, IL, IN, IA, LA, ME, MD, MA, MI, MN, MS, MO, NE, NV, NH, NJ, NM, ND, OR, PA, SD, TN, TX, VA, WA, WI, WY

  • States without Epclusa Coverage: AL, AK, DE, FL, ID, KS, KY, MT, NY, NC, OH, OK, RI, SC, UT, VT, WV, D.C.

  • Territories with Epclusa Coverage: P.R.

Figure 5. April 2021 ADAP Coverage - Epclusa Map Key: Yellow = Epclusa Coverage; Red = No Epclusa Coverage/No Information regarding Epclusa Coverage

Figure 5. April 2021 ADAP Coverage - Epclusa

Map Key: Yellow = Epclusa Coverage; Red = No Epclusa Coverage/No Information regarding Epclusa Coverage

Vosevi

  • States with Vosevi Coverage: CA, CT, HI, IL, IN, IA, LA, MD, MA, MN, NE, NV, NH, NJ, NM, ND, OR, SD, TN, WA, WY

  • States without Vosevi Coverage: AL, AK, AZ, AR, CO, DE, FL, GA, ID, KS, KY, ME, MI, MS, MO, MT, NY, NC, OH, OK, PA, RI, SC, TX, UT, VT, VA, WV, WI, , D.C.

  • Territories with Vosevi Coverage: P.R.

Figure 6. April 2021 ADAP Coverage - Vosevi Map Key: Yellow = Vosevi Coverage; Red = No Vosevi Coverage/No Information regarding Vosevi Coverage

Figure 6. April 2021 ADAP Coverage - Vosevi

Map Key: Yellow = Vosevi Coverage; Red = No Vosevi Coverage/No Information regarding Vosevi Coverage

Mavyret

  • States with Mavyret Coverage: AL, AZ, AR, CA, CO, CT, FL, GA, HI, IL, IN, IA, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OR, PA, SD, TN, VA, WA, WV, WI, WY, D.C.

  • States without Mavyret Coverage: AK, DE, ID, KS, KY, OH, OK, RI, SC, TX, UT, VT,

  • Territories with Mavyret Coverage: P.R.

Figure 7. April 2021 ADAP Coverage - Mavyret  Map Key: Yellow = Mavyret Coverage; Red = No Mavyret Coverage/No Information regarding Mavyret Coverage

Figure 7. April 2021 ADAP Coverage - Mavyret

Map Key: Yellow = Mavyret Coverage; Red = No Mavyret Coverage/No Information regarding Mavyret Coverage

Pegasys

  • States with Pegasys Coverage: AL, CA, CO, CT, DE, HI, IL, IA, LA, ME, MD, MA, MI, MN, NE, NV, NH, NJ, NM, NC, ND, OR, PA, RI, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY, D.C.

  • States without Pegasys Coverage: AK, AZ, AR, FL, GA, ID, IN, KS, KY, MS, MO, MT, NY, OH, OK, SC, TN, TX, UT, VT, VA,

  • Territories with Pegasys Coverage: None/Unknown

Figure 8. April 2021 ADAP Coverage - Pegasys Map Key: Yellow = Pegasys Coverage; Red = No Pegasys Coverage/No Information regarding Pegasys Coverage

Figure 8. April 2021 ADAP Coverage - Pegasys

Map Key: Yellow = Pegasys Coverage; Red = No Pegasys Coverage/No Information regarding Pegasys Coverage

Harvoni (generic)

  • States with Harvoni (generic) Coverage: AZ, AR, CA, CT, FL, IL, IA, ME, MD, MA, MN, MS, NE, NV, NH, NJ, NM, NC, ND, OK, OR, PA, SD, TN, WA, WI, WY, D.C.

  • States without Harvoni (generic)Coverage: AL, AK, CO, DE, GA, HI, ID, IN, KS, KY, LA, MI, MO, MT, NY, OH, RI, SC, TX, UT, VT, VA, WV

  • Territories with Harvoni (generic) Coverage: P.R.

Figure 9. April 2021 ADAP Coverage - Harvoni (Generic) Map Key: Yellow = Harvoni (Generic) Coverage; Red = No Harvoni (Generic) Coverage/No Information regarding Harvoni (Generic) Coverage

Figure 9. April 2021 ADAP Coverage - Harvoni (Generic)

Map Key: Yellow = Harvoni (Generic) Coverage; Red = No Harvoni (Generic) Coverage/No Information regarding Harvoni (Generic) Coverage

Epclusa (generic)

  • States with Epclusa (generic) Coverage: AZ, AR, CA, CT, IL, IN, IA, ME, MD, MA, MN, MS, NE, NV, NH, NJ, NM, ND, OR, PA, RI, SC, SD, TN, WA, WI, WY, D.C.

  • States without Epclusa (generic) Coverage: AL, AK, CO, DE, FL, GA, HI, ID, IN, KS, KY, LA, MS, MO, MT, NY, NC, OH, OK, RI, SC, TX, UT, VT, VA, WV

  • Territories with Epclusa (generic) Coverage: P.R.

Figure 10. April 2021 ADAP Coverage - Epclusa (generic) Map Key: Yellow = Epclusa (generic) Coverage; Red = No Epclusa (generic) Coverage/No Information regarding Epclusa (generic) Coverage

Figure 10. April 2021 ADAP Coverage - Epclusa (generic)

Map Key: Yellow = Epclusa (generic) Coverage; Red = No Epclusa (generic) Coverage/No Information regarding Epclusa (generic) Coverage

April 2021 Notes:

  • States with Open Formularies: IL, IA, MA, MN, NE, NH, NJ, NM, ND, OH, OR, WA, WY

    • N.B. – Although Ohio is listed by NASTAD as having an open formulary, both NASTAD’s ADAP Formulary Database and Ohio’s ADAP website indicates that the state does not offer any treatment for HCV

    • N.B. – Although North Dakota has adopted an open formulary, they provide only co-pay and deductible assistance for HCV medications

    • N.B. – Wyoming's ADAP Open Formulary document, the following disclaimer related to HCV is made: Hepatitis C treatment medications (i.e. Harvoni, Sovaldi, Ribavirin, Zepatier, Epclusa) must be prior authorized. To be eligible, clients must have applied for prior authorization from their insurance plan and the WY ADAP Hepatitis C Treatment checklist must be completed and signed by the provider and client

  • Colorado’s ADAP offers five coverage options – Standard ADAP, HIV Medical Assistance Program (HMAP), Bridging the Gap Colorado (BTGC), HIV Insurance Assistance Program (HIAP), and Supplemental Wrap Around Program (SWAP). ‘Yes’ indications in Figure 1. for Colorado denote that at least one of these programs offers coverage for each respective drug. The Standard ADAP Formulary covers medications only if funds are available to do so.

  • GA ADAP notes the following: “Georgia ADAP Hepatitis C Program is currently on HOLD until future funding is available. Please utilize Patient Assistance Programs (PAP’s) for Hepatitis C medications.”

  • Louisiana’s ADAP (Louisiana Health Access Program – LA HAP) offers two coverage options – Uninsured (Louisiana Drug Assistance Program – L-DAP) and Insured (Health Insurance Program – HIP). HIP pays for the cost of treatment only if the client’s primary insurance covers the drug under its formulary.

  • TX ADAP has reduced coverage of all HCV medications except Epclusa (brand)

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3. MEDICAID PROGRAMS & HCV THERAPIES

All 50 states and the District of Columbia continue to offer some form of HCV coverage. All 50 states and the District of Columbia have expanded their Preferred Drug Lists to include at least one HCV Direct Acting Agent (DAA).

April 2021 Updates:

Basic Coverage

  • States with Basic HCV Medications Coverage: AL, AK, AZ, AR, CA, CO, CT, DE, FL, GA, HI, ID, IL, IN, IA, KY, LA, ME, MD, MI, MN, MS, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OR, PA, RI, SD, TN, TX, UT, VT, VA, WA, WV, WI, D.C.

  • States without Basic HCV Medications Coverage: KS, MA, MO, OK, SC, WY

Figure 11. April 2021 Medicaid Coverage - Basic HCV Medications Map Key: Blue = Basic HCV Medication Coverage; Yellow = No Basic HCV Medication Coverage/No Information regarding Basic HCV Medication Coverage

Figure 11. April 2021 Medicaid Coverage - Basic HCV Medications

Map Key: Blue = Basic HCV Medication Coverage; Yellow = No Basic HCV Medication Coverage/No Information regarding Basic HCV Medication Coverage

Sovaldi

  • States with Sovaldi Coverage: AK, AR, CA, CO, DE, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NY, NC, ND, OH, OK, PA, RI, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY, D.C.

  • States without Sovaldi Coverage: AL, AZ, CT, FL, MA, NM, OR, SC

Figure 12. April 2021 Medicaid Coverage - Sovaldi Map Key: Blue = Sovaldi Coverage; Yellow = No Sovaldi Coverage/No Information regarding Sovaldi Coverage

Figure 12. April 2021 Medicaid Coverage - Sovaldi

Map Key: Blue = Sovaldi Coverage; Yellow = No Sovaldi Coverage/No Information regarding Sovaldi Coverage

Harvoni

  • States with Harvoni Coverage: AL, AK, AR, CA, CO, DE, GA, HI, IL, IN, IA, KS, KY, LA, ME, MD, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NY, NC, ND, OK, PA, RI, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY, D.C.

  • States without Harvoni Coverage: AZ, CT, FL, ID, MA, NM, OH, OR, SC

Figure 13. April 2021 Medicaid Coverage - Harvoni Map Key: Blue = Harvoni Coverage; Yellow = No Harvoni Coverage/No Information regarding Harvoni Coverage

Figure 13. April 2021 Medicaid Coverage - Harvoni

Map Key: Blue = Harvoni Coverage; Yellow = No Harvoni Coverage/No Information regarding Harvoni Coverage

Zepatier

States with Zepatier Coverage: AL, AK, AR, CA, CO, DE, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NY, NC, ND, OH, PA, RI, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY, D.C.

  • States without Zepatier Coverage: AZ, CT, FL, MA, NM, OK, OR, SC

Figure 14. April 2021 Medicaid Coverage - Zepatier  Map Key: Blue = Zepatier Coverage; Yellow = No Zepatier Coverage/No Information regarding Zepatier Coverage

Figure 14. April 2021 Medicaid Coverage - Zepatier

Map Key: Blue = Zepatier Coverage; Yellow = No Zepatier Coverage/No Information regarding Zepatier Coverage

Epclusa

  • States with Epclusa Coverage: AL, AK, AR, CA, CO, CT, GA, HI, IL, IN, KS, KY, LA, ME, MI, MN, MS, MO, MT, NV, NH, NJ, NM, NY, NC, ND, OK, OR, PA, RI, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY, D.C.

  • States without Epclusa Coverage: AZ, DE, FL, ID, IW, MD, MA, NE, OH, SC

Figure 15. April2021 Medicaid Coverage - Epclusa Map Key: Blue = Epclusa Coverage; Yellow = No Epclusa Coverage/No Information regarding Epclusa Coverage

Figure 15. April2021 Medicaid Coverage - Epclusa

Map Key: Blue = Epclusa Coverage; Yellow = No Epclusa Coverage/No Information regarding Epclusa Coverage

Vosevi

  • States with Vosevi Coverage: AK, AR, CO, CT, DE, FL, GA, HI, ID, IL, IN, KS, KY, LA, ME, MD, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NY, NC, ND, OH, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY, D.C.

  • States without Vosevi Coverage: AL, AZ, CA, IA, MA, NM, OK, OR

Figure 16. April 2021 Medicaid Coverage - Vosevi Map Key: Blue = Vosevi Coverage; Yellow = No Vosevi Coverage/No Information regarding Vosevi Coverage

Figure 16. April 2021 Medicaid Coverage - Vosevi

Map Key: Blue = Vosevi Coverage; Yellow = No Vosevi Coverage/No Information regarding Vosevi Coverage

Mavyret

  • States with Mavyret Coverage: AL, AK, AZ, AR, CA, CO, CT, DE, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY, D.C.

  • States without Mavyret Coverage: OK

Figure 17. April 2021 Medicaid Coverage - Mavyret  Map Key: Blue = Mavyret Coverage; Yellow = No Mavyret Coverage/No Information regarding Mavyret Coverage

Figure 17. April 2021 Medicaid Coverage - Mavyret

Map Key: Blue = Mavyret Coverage; Yellow = No Mavyret Coverage/No Information regarding Mavyret Coverage

Pegasys

  • States with Pegasys Coverage: AK, AZ, CA, CO, DE, FL, GA, HI, ID, IL, IN, IA, KY, LA, ME, MD, MI, MN, MS, MT, NE, NV, NH, NJ, NM, NY, NC, OH, OR, PA, RI, SD, TN, TX, VT, VA, WA, WV, WI, D.C.

  • States without Pegasys Coverage: AL, AR, CT, KS, MA, MO, ND, OK, SC, UT, WY

Figure 18. April 2021 Medicaid Coverage - Pegasys  Map Key: Blue = Pegasys Coverage; Yellow = No Pegasys Coverage/No Information regarding Pegasys Coverage

Figure 18. April 2021 Medicaid Coverage - Pegasys

Map Key: Blue = Pegasys Coverage; Yellow = No Pegasys Coverage/No Information regarding Pegasys Coverage

Harvoni (generic)

  • States with Harvoni (generic) Coverage: AL, AK, AR, CA, CO, DE, GA, HI, IL, IN, IA, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NY, NC, ND, OH, OK, PA, RI, SD, TN, TX, UT, VT, VA, WA, WV, WI, D.C.

  • States without Harvoni (generic) Coverage: AZ, CT, FL, ID, KS, NM, OR, SC, WY

Figure 19. April 2021 Medicaid Coverage - Harvoni (generic)  Map Key: Blue = Harvoni (generic) Coverage; Yellow = No Harvoni (generic) Coverage/No Information regarding Harvoni (generic) Coverage

Figure 19. April 2021 Medicaid Coverage - Harvoni (generic)

Map Key: Blue = Harvoni (generic) Coverage; Yellow = No Harvoni (generic) Coverage/No Information regarding Harvoni (generic) Coverage

Epclusa (generic)

  • States with Epclusa (generic) Coverage: AL, AK, AZ, AR, CA, CO, DE, FL, GA, HI, IL, IN, KY, LA, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, D.C.

  • States without Epclusa (generic) Coverage: CT, ID, IA, KS, ME, WY

Figure 20. April 2021 Medicaid Coverage - Epclusa (generic) Map Key: Blue = Epclusa (generic) Coverage; Yellow = No Epclusa (generic) Coverage/No Information regarding Epclusa (generic) Coverage

Figure 20. April 2021 Medicaid Coverage - Epclusa (generic)

Map Key: Blue = Epclusa (generic) Coverage; Yellow = No Epclusa (generic) Coverage/No Information regarding Epclusa (generic) Coverage

April 2021 Notes:

  • The follow states’ Medicaid programs offer multiple coverage plans for their respective Medicaid clients. The plan highlighted in bold typeface represents the most comprehensive plan with the most drugs covered in the respective state:

    • Hawaii – (1.) Advantage Plus; (2.) QUEST Integration

    • New Jersey – (1.) Aetna; (2.) AmeriGroup NJ; (3.) Horizon NJ Health; (4.) UnitedHealthcare of New Jersey; (5.) WellCare

    • New Mexico – (1.) BlueCross BlueShield of New Mexico; (2.) Presbyterian Centennial Care; (3) Western Sky Community Care

    • Kentucky has a Unified Medicaid Formulary

    • Louisiana has a Unified Medicaid Formulary

    • Ohio – Ohio has a Unified Medicaid Formulary that applies to all MCOs

  • No data is has been made available by the Medicaid programs in the U.S. Territories

  • KS, MA, MO, OK, SC, WY Medicaid Programs have moved to only covering Direct-Acting Antivrials

*Medicaid coverage excludes patients from most drug manufacturer patient assistance programs (PAPs)

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4. VETERANS PROGRAMS & HCV THERAPIES

The Veteran's Administration (VA) currently offers coverage for all HCV drugs. This is according to the most recent VA National Formulary, dated July 2018 (U.S. Dept. of V.A., 2018a). The VA Treatment Considerations and Choice of Regimen for HCV-Mono-Infected and HIV/HCV Co-Infected Patients (U.S. Dept. of V.A., 2018b) lists the following therapies as preferred treatments:

Abbreviations:

- CTP – Child-Turcotte-Pugh (score used to assess severity of cirrhosis)
- IU/mL – International Units Per Milliliter
- PEG-IFN/IFN – Peginterferon/Interferon
- RAS – Resistance-associated substitutions
- RBV – Ribavirin

Genotype 1:

  • Treatment-naïve without or with cirrhosis (CTP A):

    • Zepatier: 1 tablet orally daily for 12 weeks if GT1a without baseline NS5A RAS or GT1b

    • Mavyret: 3 tablets orally daily with food

  • If non-cirrhotic: 8 weeks

  • If cirrhotic: 12 weeks

    • Harvoni: 1 tablet orally daily

  • If HCV-monoinfected, non-cirrhotic, and baseline HCV RNA <6 million IU/mL: 8 weeks

  • If cirrhotic, baseline HCV RNA ≥6 million IU/mL or HIV/HCV coinfected: 12 weeks

  • Consider adding RBV in cirrhotic patients

    • Epclusa: 1 tablet orally daily for 12 weeks

  • Treatment-naïve with decompensated cirrhosis (CTP B or C):

    • Harvoni: 1 tablet orally daily + RBV (600 mg/day and increase by 200 mg/day every 2 weeks only as tolerated) for 12 weeks

    • Epclusa: 1 tablet orally daily + RBVd for 12 weeks; start at lower RBV doses as clinically indicated (e.g., baseline Hgb).

  • Treatment-experienced (NS5A- and SOF-naïve [e.g., failed PEG-IFN/RBV ± NS3/4A PI]) without or with cirrhosis (CTP A)

    • Zepatier: 1 tablet orally daily for 12 weeks if GT1b, or if failed only PEG-IFN/RBV and GT1a without baseline NS5A RAS

    • Mavyret: 3 tablets orally daily with food

  • If PEG-IFN/RBV-experienced: 8 weeks if non-cirrhotic or 12 weeks if cirrhotic

  • If NS3/4A PI + PEG-IFN/RBV-experienced: 12 weeks

    • Harvoni: 1 tablet orally daily for 12 weeks; add RBVd if cirrhotic

    • Epclusa: 1 tablet orally daily for 12 weeks

  • Treatment-experienced (NS5A-naïve and SOF-experienced) without or with cirrhosis (CTP A)

    • Mavyret: 3 tablets orally daily with food

  • If PEG-IFN/RBV + Sovaldi-experienced: 8 weeks if non-cirrhotic or 12 weeks if cirrhotic

  • If Olysio + Sovaldi-experienced: 12 weeks

    • Epclusa: 1 tablet orally daily for 12 weeks if GT1b

  • Treatment-experienced (prior NS5A-containing regimen) without or with cirrhosis (CTP A)

    • Mavyret: 3 tablets orally daily with food for 16 weeks if failed only an NS5A inhibitor without NS3/4A PI (e.g., Harvoni)

    • Vosevi: 1 tablet orally daily with food for 12 weeks

  • Treatment-experienced with decompensated cirrhosis (CTP B or C)

    • Epclusa: 1 tablet orally daily + RBV; start at lower RBV doses as clinically indicated (e.g., baseline Hgb);

  • If NS5A-naïve: 12 weeks

  • If NS5A-experienced: 24 weeks; NOT FDA approved for 24 weeks

Genotype 2:

  • Treatment-naïve or treatment-experienced (PEG-IFN/IFN ± RBV or Sovaldi + RBV ± PEG-IFN) without or with cirrhosis (CTP A)

    • Mavyret: 3 tablets orally daily with food

  • If non-cirrhotic: 8 weeks

  • If cirrhotic: 12 weeks

    • Epclusa: 1 tablet orally daily for 12 weeks

  • Treatment-experienced (NS5A-experienced) without or with cirrhosis (CTP A)

    • Vosevi: 1 tablet orally daily with food for 12 weeks

  • Treatment-naïve or treatment-experienced patients with decompensated cirrhosis (CTP B or CTP C)

    • Epclusa: 1 tablet orally daily + RBV; start at lower RBV doses as clinically indicated (e.g., baseline Hgb)

  • If NS5A-naïve: 12 weeks

  • If NS5A-experienced: 24 weeks

Genotype 3:

  • Treatment-naïve without cirrhosis or with cirrhosis (CTP A)

    • Mavyret: 3 tablets orally daily with food for 12 weeks

    • Epclusa: 1 tablet orally daily for 12 weeks

  • If CTP A, test for NS5A RAS

  • Add RBV if Y93H RAS present

  • Treatment-experienced (PEG-IFN ± RBV or Sovaldi + RBV ± PEG-IFN) without or with cirrhosis (CTP A)

    • Mavyret: 3 tablets orally daily with food for 16 weeks

  • Treatment-experienced (NS5A-experienced) without or with cirrhosis (CTP A)

    • Vosevi: 1 tablet orally daily with food for 12 weeks

  • If CTP A, consider adding RBV (no supporting data)

  • Treatment-naïve or treatment-experienced with decompensated cirrhosis (CTP B or CTP C)

    • Epclusa: 1 tablet orally daily + RBV; start at lower RBV doses as clinically indicated (e.g., baseline Hgb)

  • If NS5A-naïve: 12 weeks

  • If NS5A-experienced: 24 weeks

Genotype 4:

  • Treatment-naïve without or with cirrhosis (CTP A)

    • Zepatier: 1 tablet orally daily for 12 weeks

    • Mavyret: 3 tablets orally daily with food

  • If non-cirrhotic: 8 weeks

  • If cirrhotic: 12 weeks

    • Harvoni: 1 tablet orally daily for 12 weeks

    • Epclusa: 1 tablet orally daily for 12 weeks

  • Treatment-naïve with decompensated cirrhosis (CTP B or C)

    • Harvoni: 1 tablet orally daily + RBV (600 mg/day and increase by 200 mg/day every 2 weeks only as tolerated) for 12 weeks

    • Epclusa: 1 tablet orally daily + RBV for 12 weeks; start at lower RBV doses as clinically indicated (e.g., baseline Hgb)

  • Treatment-experienced (Sovaldi-experienced and NS5A-naïve) without or with cirrhosis (CTP A)

    • Mavyret: 3 tablets orally daily with food for 12 weeks

    • Epclusa: 1 tablet orally daily + RBV for 12 weeks; start at lower RBV doses as clinically indicated (e.g., baseline Hgb)

  • Treatment-experienced (NS5A-experienced) without or with cirrhosis (CTP A)

    • Vosevi: 1 tablet orally daily with food for 12 weeks

  • Treatment-experienced with decompensated cirrhosis (CTP B or CTP C)

    • Epclusa: 1 tablet orally daily + RBV; start at lower RBV doses as clinically indicated (e.g., baseline Hgb)

      • If NS5A-naïve: 12 weeks

      • If NS5A-experienced: 24 weeks; NOT FDA approved for 24 weeks

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5. PATIENT ASSISTANCE PROGRAMS

The drug manufacturers and various national nonprofit organizations offer a variation of patient assistance programs (PAPs) to assist patients in accessing treatments. They include:

Support Path (Gilead Sciences):

  • Financial Assistance

    • Provides Co-Pay Coupons for Sovaldi, Harvoni, Harvoni (Generic), Epclusa, Epclusa (Generic), and Vosevi

    • Co-Pay Coupons cover out-of-pocket costs up to 25% of the catalog price of a 12-week regimen (3 bottles/packages) of Sovaldi, Harvoni, Harvoni (Generic), Epclusa, Epclusa (Generic), or Vosevi

    • Excludes patients enrolled in Medicare Part D or Medicaid

  • Insurance Support

    • Researches and verifies patient’s benefits, and gives information they need about coverage options and policies

    • Explain Prior Authorization process and works with HCV Specialist’s office so they can submit PA forms to a patient’s insurance company

    • May be able to provide assistance with appeals process

  • Website: http://www.mysupportpath.com/

AbbVie Mavyret Co-Pay Savings Card:

  • Financial Assistance

    • Patient may be eligible to pay as little as $5

    • Excludes patients enrolled in Medicare Part D, Medicare Advantage, Medigap, Medicaid, TRICARE, Department of Defense, or Veterans Affairs programs)

  • Website: https://www.mavyret.com/copay-savings-card

NeedyMeds:

  • NeedyMeds Drug Discount Card

    • Designed to lower cost of prescription medications by up to 80% at participating pharmacies

    • NeedyMeds DOES NOT keep a list of prescription medications covered

    • No eligibility requirements

    • Patients CANNOT be enrolled in any insurance

    • CANNOT be used in combination with government healthcare programs, but CAN be used IN PLACE of program

    • CANNOT be combined with other offers

  • Website: http://ow.ly/fEJo309cJ7Z

The Assistance Fund:

  • Status: CLOSED

  • Requires provider referral

  • Copay assistance

  • Eligibility Criteria:

    • US citizen or permanent resident

    • Diagnosed with the disease for which you are applying

    • Prescribed an FDA-approved treatment for the disease

    • Have prescription coverage for the prescribed treatment

    • Meet financial eligibility criteria based upon household income and size

  • Website: https://tafcares.org/patients/covered-diseases/

Patient Advocate Foundation Co-Pay Relief:

  • Status: CLOSED

  • Maximum award of $15,000

  • Eligibility Requirements:

    • Patient must be insured, and insurance must cover prescribed medication

    • Confirmed HCV diagnosis

    • Reside and receive treatment in the U.S.

    • Income falls below 400% of FPL with consideration of the Cost of Living Index (COLI) and the number in the household

  • Website: https://www.copays.org/diseases/hepatitis-c

Patient Access Network (PAN) Foundation:

HealthWell Foundation:

  • Status: OPEN

  • Co-Pay Assistance with a maximum award of $30,000

  • Minimum Co-Pay Reimbursement Amount: None

  • Minimum Premium Reimbursement Amount: None

  • Eligibility Requirements:

    • Must be being treated for HCV

    • Have insurance that covers HCV prescribed medication

    • Income falls below 500% of FPL

    • Receiving treatment in the U.S.

  • Website: https://www.healthwellfoundation.org/fund/hepatitis-c/

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6. HARM REDUCTION PROGRAMS

Harm Reduction, as it relates to opioid abuse and HCV, are measures designed to serve as preventive or monitoring efforts in combating opioid prescription drug and heroin abuse, and as an effect, helping to prevent the spread of HCV and HIV. The Co-Infection Watch covers the following measures: Syringe Exchange, Expanded Naloxone Access, Good Samaritan Laws, Mandatory PDMP Reporting, Doctor Shopping Laws, Physical Exam Requirements, ID Requirements for Purchase, Required or Recommended Prescriber Education, and Lock-In Programs (Editor’s Note: Program descriptions provided herein).

April 2021 Updates:

Syringe Exchange

Syringe Services Programs (SSPs) exist to provide injection drug users (or those whose prescriptions require injection) with clean syringes and/or in exchange for used ones. (N.b. – states listed as "at least one SSP…” indicate only that a Syringe Services Program (SSP) exists within the state, regardless of the legality of SSPs under state law).

  • States with Syringe Exchange: AK, AZ, AR, CA, CO, CT, DE, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MO, MT, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, RI, SC, TN, TX, UT, VT, VA, WA, WV, WI, D.C.

  • States without Syringe Exchange: AL, MS, NE, SD, WY

  • Territories with Syringe Exchange: Puerto Rico, U.S. Virgin Islands

Figure 21. April 2021 Syringe Exchange Coverage Map Key: Purple = Syringe Exchange(s); Red = No Syringe Exchange(s); Grey = No Information

Figure 21. April 2021 Syringe Exchange Coverage

Map Key: Purple = Syringe Exchange(s); Red = No Syringe Exchange(s); Grey = No Information

Expanded Naloxone

Naloxone is a drug used to counteract the effects of opioid overdoses. Expanded Access refers to one of more of the following conditions: Naloxone purchase without a prescription; availability to schools, hospitals, and emergency response units for use in the event of an overdose.

  • States with Expanded Naloxone: AL, AK, AZ, AR, CA, CO, CT, DE, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MO, MS, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY, D.C.

  • States without Expanded Naloxone: None

  • Territories with Expanded Naloxone: Unknown

Figure 22. April 2021 Expanded Naloxone Coverage Map Key: Purple = Expanded Naloxone; Red = Restricted Naloxone; Gray = No Information

Figure 22. April 2021 Expanded Naloxone Coverage

Map Key: Purple = Expanded Naloxone; Red = Restricted Naloxone; Gray = No Information

Good Samaritan Laws

Good Samaritan Laws are laws that are designed to protect emergency services personnel, public or private employees, and/or citizens from being held legally liable for any negative healthcare outcomes as a result of providing "reasonable measures" of emergent care.

  • States with Samaritan Laws: AL, AK, AZ, AR, CA, CO, CT, DE, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MO, MS, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY, D.C.

  • States without Samaritan Laws: None

  • Territories with Samaritan Laws: Unknown

Figure 23. April 2021 Good Samaritan Laws Coverage Map Key: Purple = Good Samaritan Laws; Red = No Good Samaritan Laws; Gray: No Information

Figure 23. April 2021 Good Samaritan Laws Coverage

Map Key: Purple = Good Samaritan Laws; Red = No Good Samaritan Laws; Gray: No Information

Mandatory PDMP Reporting

Prescription Drug Monitoring Programs (PDMPs) are programs established by state and/or federal law that requires prescribing physicians and the fulfilling pharmacies to report to a state agency one or more of the following data points: Patient Names; Specific Drug(s) Prescribed; Prescription Dosage; Date; Time; Form of State-Issued ID.

  • States with PDMP Reporting: AK, AZ, AR, CA, CT, DE, FL, GA, HI, IL, IN, IA, KY, LA, ME, MD, MA, MI, NE, NV, NH, NM, NY, NC, ND, OH, OK, OR, PA, RI, SC, TN, UT, VT, VA, WV, WI

  • States without PDMP Reporting: AL, CO, ID, KS, MN, MS, MO, MT, NJ, SD, TX, WA, WY, D.C.

  • Territories with PDMP Reporting: Guam

Figure 24. April 2021 Mandatory Prescription Drug Monitoring Program Coverage Map Key: Purple = Mandatory PDMP; Red = No Mandatory PDMP; Gray = No Information

Figure 24. April 2021 Mandatory Prescription Drug Monitoring Program Coverage

Map Key: Purple = Mandatory PDMP; Red = No Mandatory PDMP; Gray = No Information

Doctor Shopping Laws

Doctor Shopping Laws are those laws designed to prevent patients from seeking one or more of the same prescription from multiple doctors through the use of subterfuge, falsifying identity, or any other deceptive means. While federal law prohibits Doctor Shopping, most states also include provisions that prohibit patients from seeking a new prescription if another physician has denied a similar prescription within a certain period of time.

  • States with Doctor Shopping Laws: AL, AK, AZ, CA, CO, CT, DE, FL, GA, HI, IL, IN, IA, KY, LA, ME, MD, MA, MI, MS, MT, NE, NV, NH, NJ, NY, NC, ND, OH, OK, PA, SC, SD, TN, TX, UT, VT, WV, WI, WY

  • States without Doctor Shopping Laws: AR, ID, KS, MN, MO, NM, OR, RI, VA, WA, D.C.

  • Territories with Doctor Shopping Laws: None

Figure 25. April 2021 Doctor Shopping Laws CoverageMap Key: Purple = Doctor Shopping Laws; Red = No Doctor Shopping Laws; Grey = No Information

Figure 25. April 2021 Doctor Shopping Laws Coverage

Map Key: Purple = Doctor Shopping Laws; Red = No Doctor Shopping Laws; Grey = No Information

Physical Exam Required

Physical Exam Requirements are those that mandate that the prescribing physician perform a physical examination on a patient before providing a prescription for a controlled substance to determine if the prescription is medically necessary.

  • States with Physical Exam Required: AL, AK, AZ, AR, CA, CO, CT, DE, FL, GA, HI, ID, IL, IN, IA, KY, LA, ME, MN, MO, MS, NE, NV, NH, NJ, NM, NC, ND, OH, OK, PA, RI, SC, TN, TX, UT, VA, WA, WV, D.C.

  • States without Physical Exam Required: KS, MD, MA, MI, MT, NY, OR, SD, VT, WI, WY

  • Territories with Physical Exam Required: None

Figure 26. April 2021 Physical Exam Required Coverage Map Key: Purple = Physical Exam Required; Red: No Physical Exam Required; Grey = No Information

Figure 26. April 2021 Physical Exam Required Coverage

Map Key: Purple = Physical Exam Required; Red: No Physical Exam Required; Grey = No Information

I.D. Required for Purchase of Opioid Prescription

Federal law requires anyone purchase a controlled substance to provide a state-issued identification (“I.D.”) in order to fill the prescription. Mandatory ID requirements go further and require that this information be recorded and stored in an effort to prevent the same patient from obtaining multiple or repeated prescriptions in a given period of time.

  • States with I.D. Required: CT, DE, FL, GA, HI, ID, IL, IN, LA, ME, MA, MI, MN, MT, NV, NM, NY, NC, ND, OK, OR, SC, TX, VT, VA, WV, WI

  • States without I.D. Required: AL, AK, AZ, AR, CA, CO, IA, KS, KY, MD, MS, MO, NE, NH, NJ, OH, PA, RI, SD, TN, UT, WA, WY, D.C.

  • Territories with I.D. Required: Unknown

Figure 27. April 2021 I.D. Required Coverage Map Key: Purple = I.D. Required; Red = No I.D. Required; Gray = No Information

Figure 27. April 2021 I.D. Required Coverage

Map Key: Purple = I.D. Required; Red = No I.D. Required; Gray = No Information

Prescriber Education Required/Recommended

States that require/do not require that prescribing physicians undergo special training related to safer prescribing and utilization practices.

  • States with Prescriber Education Required: AL, AK, AZ, AR, CA, CO, CT, DE, FL, GA, HI, ID, IL, IN, IA, KY, LA, ME, MD, MA, MI, MN, MS, NE, NV, NH, NJ, NM, NY, NC, OH, OK, OR, PA, RI, SC, TN, TX, UT, VT, VA, WA, WV, WI, D.C.

  • States without Prescriber Education Required: KS, MO, MT, ND, SD, WY

  • Territories with Prescriber Education Required: Unknown

Figure 28. April 2021 Prescriber Education Required Coverage Map Key: Purple = Prescriber Ed Required; Red = No Prescriber Ed Required; Gray = No Information

Figure 28. April 2021 Prescriber Education Required Coverage

Map Key: Purple = Prescriber Ed Required; Red = No Prescriber Ed Required; Gray = No Information

Medicaid Lock-In Program

Lock-In Programs are laws requiring that patients either receive prescriptions from only one physician and/or fill prescriptions from only one pharmacy.

  • States with Medicaid Lock-In Program: AL, AK, AZ, AR, CO, CT, DE, GA, ID, IL, KS, LA, ME, MD, MA, MI, MN, MO, MS, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, RI, SC, TN, UT, VT, VA, WA, WV, WI, WY, D.C.

  • States without Medicaid Lock-In Program: CA, FL, HI, IN, IA, KY, SD, TX

  • Territories with Medicaid Lock-In Program: Unknown

Figure 29. April 2021 Medicaid Lock-In Coverage Map Key: Purple = Medicaid Lock-In; Red = No Medicaid Lock-In; Gray = No InformationApril 2021 Notes:In March of 2020, the DEA issued guidance regarding telehealth and physical exam requirements throug…

Figure 29. April 2021 Medicaid Lock-In Coverage

Map Key: Purple = Medicaid Lock-In; Red = No Medicaid Lock-In; Gray = No Information

April 2021 Notes:

  • In March of 2020, the DEA issued guidance regarding telehealth and physical exam requirements through the duration of the COVID-19 public health emergency, specifically with regard to physical exam requirements.

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7. COVID-19 IMPACT ON HIV & HCV

The Community Access National Network’s blog began 2021 by assessing COVID-19’s impact on HIV, HCV, and Substance-Use Disorder. We've subsequently followed-up by asking, COVID-19: How Far We’ve Come & How Far We Have to Go?

Additional Resources and Relevant Issues:

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8. LATEST NEWS

  • Michigan Improves Access to Hepatitis C Treatment for Medicaid and Healthy Michigan Plan Patients - Michigan advances in developing a Hepatitis C elimination program by directing its state-based public payors and Managed Care Plan administrators to eliminate prior authorizations for the treatment and cure of HCV. Harvard’s Center for Health Law and Policy staff writer, Phil Waters, encouraged all payors and providers to implement the policy change immediately.

  • PAF’s Co-Pay Relief Expands Assistance to Cover Insurance Premiums - Patient Access Foundation announces an expansion of their co-pay assistance program to cover premiums through their COVID-19, Cystic Fibrosis, and HIV/AIDS & Prevention funds. Program expansion seeks to address patient needs beyond co-pays and ensure equitable access to care and treatment.

  • Prioritizing Pleasure and Correcting Misinformation in the Era of U=U - Lancet article seeking to address stigma related to “undetectable equals untransmittable”. Authors argue sex-stigma, especially that from providers avoiding discussing U=U with clients for fear of “barebacking”, misunderstands the role and nature of sexual health empowerment, “pleasure advocacy”, and disempowers consumers from “being in the driver’s seat” of their own care. This disservice is not only ill-informed but unethical.

  • Extended Access Opportunity to Enroll in More Affordable Coverage Through HealthCare.Gov - In March, the Biden Administration’s CMS announced an extended pandemic-related special enrollment period (SEP). Provisions of the American Rescue Plan Act regarding premium assistance and caps expected to be accessible July 2021. Consumers will need to request “additional savings” subsidies, if they wish to access them in the immediate as opposed to claiming these savings as a tax credit through their tax filing in 2022.

  • HHS OCR and the U.S. Attorney’s Office for the Eastern District of Michigan Enter Voluntary Resolution Agreement with Michigan Bariatric Practice to Protect Patients from HIV Discrimination - March 4, 2021 press release from HHS, Office of Civil Rights, regarding a settlement agreement between the Department of Justice (DOJ) and a Michigan-based bariatric surgery clinic based on a complaint of refusal of care for a person living with HIV. DOJ cites Title III of the Americans with Disability Act and previous Supreme Court rulings extending disability protections to people living with HIV, regardless of “symptomatic” presentation. Additionally, coordinated compliance review relied upon protections offered by the Rehabilitation Act of 1974, section 504, and Section 1557 of the Affordable Care Act.

  • OCR Seeks Information on Addressing Disability Discrimination in Health Care and Child Welfare Contexts - HHS, OCR announced a “request for information” regarding discrimination in various health care settings and child welfare settings with regard to discrimination on the basis of disability. Specifically, OCR cites various rulings with regard to HIV and Substance Use Disorder stigma and discrimination and reiterated positions in opposition to such practices in the aforementioned regulated areas of public life. The RFI seeks input from stakeholders on model policy changes.

  • Merck and Gilead Announce Partnership Agreement to Explore Long-Acting HIV Therapies - Pharmaceutical giants, Merck and Gilead Sciences, announce a joint venture to develop long-acting oral and injectable therapeutics for both HIV treatment and prevention (PrEP). The agreement is expansive in nature and relies upon products in development as well as previously developed products by each company.

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9. CONTACT

Jen Laws, Project Director, HIV/HCV Co-Infection Watch

jen@tiicann.org

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10. REFERENCES

Available upon request.

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Jen Laws, President & CEO

Jen Laws (Pronouns: He/Him/His) is the President & Founder of Policy Candy, LLC, which is a non-partisan health policy analysis firm specializing in various aspects of health care and public health policy, focusing on the needs of the HIV-affected and Transgender communities. In that capacity, Jen has served as the President & CEO of the Community Access National Network (CANN), beginning in January 2022. He previously served as the Project Director of CANN's HIV/HCV Co-Infection Watch, as well as 340B Policy Consultant.

Jen began his advocacy efforts in Philadelphia in 2005, at the age of 19, coordinating team efforts for a corporation participating in the AIDS Walk. His connection to HIV advocacy grew when partnering with Mr. Friendly, a leading anti-HIV-stigma campaign.

He began working in public health policy in 2013, as a subcontractor for Broward Regional Planning Council evaluating Marketplace plans for plan year 2014, advising and educating constituents on plan selection. Jen was a member of South Florida AIDS Network and has worked with Florida Department of Health, Broward and Miami-Dade County Health Departments, Pride Center South Florida, and other local organizations to South Florida in addressing the concerns and needs of these intersecting communities. During this time, Jen was seated on the board of directors for the ADAP Advocacy Association.

Having moved to the New Orleans area in 2019, Jen resumed his community-based advocacy as the chair of Louisiana's Ending the HIV Epidemic planning subcommittee for Data-based Policy and Advocacy, regular participation as a community member and "do-gooder" with other governmental and non-governmental planning bodies across the Louisiana, and engages with other southern state planning bodies. He continues his advocacy in governmental health care policy evaluation, which has been utilized to expand access to quality healthcare by working with RAD Remedy to deliver the nation's foremost database of trans* competent health care providers. Lending his expertise on policy matters ranging from 340B impact on RW providers and patients to strategic communications and data analysis, Jen's approach to community engagement is focused on being accessible across all stakeholder groups and centering the perspectives of PLWHA and Transgender people. He is a community ambassador alumni of the CDC's Let's Stop HIV Together campaign.

In his personal life, Jen enjoys spending his time being "ridiculously wholesome" with his partner, Aisha, and her two amazing daughters. In their personal time, when not immersed in crafts or house projects, they can be found seeking opportunities to help their neighbors, friends, and community members (who have come to rightfully expect exquisite gift baskets of Aisha's homemade jams and jellies from time to time). Jen strives to set a good example both in his personal professional life of integrating values into action and extending the kindness and care that have led him to a life he calls "extraordinarily lucky".

https://tiicann.org
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Watch 03: July 2021

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Watch 01: January 2021