Policy Updates: Hill Happenings and Administration Activities

By Mike Weir July 30, 2018

Hill Happenings

FY2019 Budget and Appropriations

The Senate is expected to take up a FY2019 Labor, Health and Human Services, Educations and Related Agencies (LHHS)/Defense minibus as soon as next week. The House has officially reported out their LHHS spending bill of the full Appropriations Committee. NASTAD will continue to monitor the appropriations process and advocate for the highest funding level on behalf of HIV and hepatitis programs. NASTAD does not expect any major changes to occur when the House and Senate consider their respective bills on the floor. 

Administration Activities

ACA Risk Adjustment Payments

The Centers for Medicare and Medicaid Services (CMS) announced they will resume payments to health plans operating on the insurance exchange. Earlier this month, CMS suspended the ACA’s risk adjustment payments to health insurers. The risk adjustment program is a federal program that provides payments to issuers to offset the cost of covering sicker individuals with chronic and complex conditions. 

2018 National STD Prevention Conference

The 2018 STD Prevention Conference will be held August 27-30, 2018 in Washington, DC. Registration for the conference is open. 

2018 National Ryan White Conference on HIV Care & Treatment

The 2018 Ryan White Conference on HIV Care & Treatment will be held December 11-14, 2018 in Oxon Hill, Maryland. Late registration for the conference is still open. 

2019 National HIV Prevention Conference

The 2019 National HIV Prevention Conference (NHPC) will be held March 18-21, 2019 in Atlanta, Georgia. Check out the updated website for more information about tracks and to view the tentative conference schedule. 

International AIDS Conference Updates

The biennial International AIDS Conference (AIDS 2018) is the “largest conference on any global health issue in the world. AIDS 2018 aims to promote human rights based and evidence-informed HIV responses that are tailored to the needs of particularly vulnerable communities -- including people living with HIV, displaced populations, men who have sex with men, people in closed settings, people who use drugs, sex workers, transgender people, women and girls and young people--and collaborate in fighting the disease beyond country borders.” Below are highlights from this year’s conference which was held on July 23-27. 

Results from Partner 2 Study Released

The newly released PARTNER2 study documented 75,000 condomless anal sex acts between mixed-HIV-status men. The prospective observational study saw zero transmissions between study partners when the HIV-positive partner had a fully suppressed viral load, within those nearly 75,000 condomless sex acts.

Changes to Gilead’s Patient Assistance Program for Truvada

Effective September 1, 2018, Gilead Sciences will increase its annual benefit for Truvada from up to $4,800 to $7,200. This increase will apply to both Truvada for PrEP and Truvada for treatment as part of a complete 3-drug regimen. Enrollment terms and conditions will remain the same in Gilead’s Advancing Access program (note that Gilead’s co-pay coupon program is not available for patients enrolled in any state or federally funded prescription drug program, such as Medicare Part D and Medicaid).

Also, effective July 1, 2018, people who qualify for Gilead’s PrEP medication assistance program (MAP) will be eligible for 12 months rather than six months. 

HIV Decriminalization

Twenty of the world’s leading HIV scientists have launched an evidence-based consensus that systematically refutes the rationale for laws that criminalize HIV transmission. The “Expert Consensus Statement on the Science of HIV in the Context of Criminal Law” and an accompanying editorial is included in the Journal of the International AIDS Society (JIAS).

July 23: Day 1 Daily Delegate Digest

July 24: Day 2 Daily Delegate Digest  

July 25: Day 3 Daily Delegate Digest

July 26: Day 4 Daily Delegate Digest

July 27: Day 5 Daily Delegate Digest

Resources

NASTAD released an issue brief on The Intersection of Hepatitis, HIV, and the Opioid Crisis.

Treatment Action Group (TAG) has released their Pipeline Report: Drugs, Diagnostics, Vaccines, Preventive Technologies, Research Toward a Cure, and Immune-Based and Gene Therapies in Development

AIDS and Behavioris soliciting manuscript submissions to be considered for a special issue focused on HIV infection in the southeastern United States (the South).

Visit the new Living With HIV section, now live on the CDC HIV Basics site.

The O’Neil Institute released the following reports that ‘highlight the education and policy dialogues needed to prepare for innovative long-acting products under development to treat and prevent HIV infection’: Long-Acting HIV Treatment and Prevention Are Coming: Preparing for Potential Game Changers

The National Academy for State Health Policy has released the following report:

State Strategies to Prevent and Respond to Disease Crises Through Medicaid and Public Health Partnerships

MMWR: Access to Treatment for Hepatitis B Virus Infection — Worldwide, 2016

News Bulletin

Health Departments are Key to Eliminating Hepatitis in the United States

“World Hepatitis Day takes place every year on July 28 to raise awareness around hepatitis and opportunities to eliminate this disease. Despite significant strides in prevention and treatment, hepatitis remains one of the biggest global health threats. Ahead of this year’s observance, Murray Penner, executive director of NASTAD, reflects on what it will take to end this global epidemic and the critical role public health plays in accomplishing this important work.”

Fair Pricing Coalition Disappointed at Launch Price of Janssen’s Protease Inhibitor-based Single-tablet Regimen Symtuza

“The Fair Pricing Coalition (FPC), an ad hoc coalition of HIV and hepatitis C virus (HCV) activists, today expressed its strong dissatisfaction with Janssen Therapeutics over its launch price for Symtuza (darunavir/cobicistat/emtricitabine/tenofovir alafenamide). At a wholesale acquisition cost (WAC) of $41,784 a year, Janssen has set a record-high price for single-tablet antiretroviral regimens (STRs), ignoring the need for cost containment in HIV care and defying a groundswell of public and governmental demands for lower prescription drug prices.”

Ryan White funds not cut from current grants

“Another organization, the National Alliance of State & Territorial AIDS Directors, based in Washington, D.C., sent out a news release disagreeing with the Slate article. It explains that the Ryan White funds that were returned to the treasury were funds unspent by the program.”

PrEP for HIV Prevention: Essential for Ending the Epidemic, but Out of Reach for Many

“And while these programs have been critical in expanding access for those using them, they sometimes present consumers with barriers, most recently with copay accumulator policies, which affects those who use copay cards, explained Amy Killelea, JD, director, health systems integration, National Alliance of State and Territorial AIDS Directors (NASTAD). Under these policies, which are not highly publicized, when a consumer uses their card, it does not go toward their deductible or OOP maximum.”

Report Warns Of 'Dangerous Complacency' In The Fight Against HIV

“The report finds that efforts to prevent the spread of HIV have stalled, in part, because international funding for AIDS has begun to decline. What's more, a key finding of the report is that "the HIV pandemic is not on track to end, and the prevailing discourse on ending AIDS has bred a dangerous complacency and may have hastened the weakening of global resolve to combat HIV.”

Praise For The Global HIV Program That Trump Wants To Cut

“The 22nd annual International AIDS Conference is currently underway in Amsterdam. And several studies are looking at the U.S. government's largest foreign HIV program: the President's Emergency Plan for AIDS Relief, or PEPFAR. The multi-billion dollar program to combat HIV and AIDS globally has been slated for cuts by the Trump administration. But researchers and African health officials credit the program started by President George W. Bush with helping to change the trajectory of the AIDS epidemic. Bernard Haufiku, the current minister of health for Namibia, says that for his small southern African nation, the impact of AIDS has been enormous.”

Fauci: HIV Remission Free of Antiretroviral Therapy Is a Feasible Goal

“Long-lasting control of HIV infection without antiretroviral therapy (ART) is a feasible goal that deserves vigorous pursuit, Anthony S. Fauci, M.D., will assert during a lecture on Wednesday, July 25 at the 22nd International AIDS Conference (AIDS 2018)in Amsterdam. Dr. Fauci directs the National Institute of Allergy and Infectious Diseases (NIAID), part of the U.S. National Institutes of Health. His lecture is titled, “Durable Control of HIV Infection in the Absence of Antiretroviral Therapy: Opportunities and Challenges.”

Governor Cuomo Announces First-In-Nation Strategy To Eliminate Hepatitis C

“Governor Andrew M. Cuomo today announced the nation's first strategy to eliminate hepatitis C, including the establishment of a Hepatitis C Elimination Task Force that will advise the state as it implements its plan going forward. The elimination effort aims to stop the spread of the virus by increasing access to medications that can cure hepatitis C and expanding programs to connect New Yorkers with prevention, screening and treatment services. Hepatitis C, or HCV, is a liver disease caused by the hepatitis C virus affecting more than 200,000 New Yorkers.”

Job Opportunities

Capstone Lead Physician – Georgia 

Cobb and Douglas Public Health is hiring for a Capstone Lead Physician withintheir HIV Program.

HIV Coordinator – Wisconsin 

The Wisconsin Department of Health Services (DHS), Division of Public Health (DPH) is recruiting to fill an HIV Partner Services Coordinator position and an HIV Data to Care Coordinator position within the Bureau of Communicable Diseases.

Executive Director/Administrator –Texas

The Austin Harm Reduction Coalition is hiring for an Executive Director/Administrator withintheir HIV Program.