LAUSR

Key Points Question How is the cost burden of antiretroviral therapy and preexposure prophylaxis for HIV treatment and prevention distributed to patients and other payers under Medicare Part D? Findings In this nationwide cross-sectional analysis of 2019 Part D plans, the median prices of antiretroviral therapy exceeded $35 000 annually, and the price of preexposure prophylaxis exceeded $20 000 annually. Patients’ projected annual out-of-pocket cost surpassed $3000, and Medicare, not insurance plans or manufacturers, paid half to two-thirds of costs. Meaning It appears that ending the HIV epidemic requires addressing the high prices of antiretroviral therapy and preexposure prophylaxis and Medicare Part D cost-sharing that jeopardize affordability for patients and incur a burden to Medicare.