Pilot Program Will Provide Drug Coverage for Uninsured Pennsylvanians with Hepatitis C and HIV

Pennsylvania’s Department of Health (DOH) announced that the state’s Special Pharmaceutical Benefits Program (SPBP) is implementing a pilot program offering no cost coverage of hepatitis C antiviral medications for individuals with a dual diagnosis of HIV and hepatitis C.

Hundreds of low-income Pennsylvanians with both hepatitis C and HIV who are enrolled in SPBP and who are either underinsured or uninsured will benefit from the program. Eligible individuals who are already enrolled in other prescription plans must use those benefits before receiving assistance from SPBP.

The $13 million, six-month program is funded through additional pharmaceutical liability recoveries made by the Department of Aging’s Pharmaceutical Assistance Contract for the Elderly program (PACE), which offers low-cost prescription medication to qualified residents, age 65 and older.

Both HIV and hepatitis C are impacting patients in Pennsylvania. The Centers for Disease Control and Prevention (CDC) reports that:

  • Pennsylvania was ranked 10th in the nation for HIV diagnoses in 2013 with 1,419 adults and adolescents diagnosed that year
  • Reported rates of acute hepatitis C in Pennsylvania increased by 100 percent between 2009 and 2013

The SPBP website offers a full list of the medications, the approval criteria, request form and additional details.

PAMED resources on HIV Testing

  • A legal brief written by PAMED’s legal counsel, which provides a general overview of the legal requirements for HIV testing under Pennsylvania’s Confidentiality of HIV-Related Information Act, including changes made by Act 59 of 2011
  • A customizable patient handout containing example language for physicians to give patients on routine HIV testing
  • An example policy for routine HIV testing

Additional resources to help physicians implement routine HIV testing in their practices are available through the Pennsylvania Expanded HIV Testing Initiative (PEHTI).