How to reduce the cost of HIV treatment

Human immunodeficiency virus (HIV) is a virus that infects and damages the immune system. Infections with HIV are chronic but manageable. HIV is managed with antiretroviral therapy (ART), medications that disrupt the lifecycle of the HIV virus, stopping it from replicating.

ART cannot cure an HIV infection, but continuous treatment with ART can keep the amount of virus in the body at very low levels. This is known as viral suppression, and it allows a person with HIV to remain healthy. It also prevents the transmission of HIV to others.

Achieving and maintaining viral suppression is the main goal of treating HIV, and the key to maintaining viral suppression is taking HIV medications exactly as prescribed by a healthcare provider. This means taking every dose, taking every dose on time, and following any other instructions a healthcare provider specifies.

Cost of treatment is a barrier to treatment

A barrier is any factor that prevents a person from accessing healthcare. Cost is a significant barrier to healthcare in general, and many people who are living with HIV have difficulty accessing treatment due to the financial cost of treatment. This includes the cost of paying for medications, as well as the cost of healthcare appointments, blood tests, and other aspects of HIV care.

Federal and state programs

If you or a loved one is living with HIV and the cost of treatment is preventing you from accessing healthcare, there are resources that can help reduce the cost of treatment. This includes state and federal programs and, in some cases, discounts from drug manufacturers. If you are searching for ways to reduce the cost of HIV treatment, the information below can help you get started.

The Ryan White HIV/AIDS Program

Part of the Health Resources & Services Administration (HRSA), the Ryan White HIV/AIDS program funds HIV healthcare and support services (such as food and housing) to people with low income who do not have health insurance. Programs vary state by state, with different eligibility requirements and application processes. You can find programs in your area by visiting the state hotlines page on the Ryan White HIV/AIDS program’s webpage.

Medicaid and Medicare

Medicaid and Medicare are the largest sources of insurance coverage for people living with HIV in the United States. If you or a loved one is living with HIV and do not have health insurance, it is worth looking into eligibility requirements and applying.

• Medicare is federally funded health insurance for people over the age of 65, as well as people who have certain disabilities. More information can be found at medicare.gov.
• Medicaid provides health insurance for people with low income and resources. Because Medicaid receives joint funding from the federal government and state government, eligibility requirements and benefits can vary state by state. More information can be found at medicaid.gov.

There is also The Children's Health Insurance Program (CHIP), which provides health insurance to children whose families earn too much to qualify for Medicaid. More information can be found on the Medicaid website.

Discounts from drug manufacturers

Drug manufacturers often have their own programs that can help lower the cost of medications. Information about these programs can be found on a drug manufacturer’s website. Most programs fall into two categories:

Copay cards

If you have private insurance (through a healthcare provider) or commercial insurance (that you have purchased on your own) you may want to explore a copay savings program, or copay card program. People who participate in these programs are issued a card that they can present when picking up and paying for a medication. Information on the card is entered along with insurance information and a discount is applied to the price of the medication.

Patient assistance programs (PAPs)

If you are uninsured or underinsured and cannot cover the cost of a medication you need, you may be eligible for a payment assistance program. These provide medications at a lower cost to those who meet the eligibility requirements (which vary depending on the program).

If you are concerned about the cost of HIV medication, talk to your healthcare provider. They may have their own recommendations on resources that can help you. Your pharmacist can also be a good source of information.