The city of Memphis ranks sixth in the country for the highest number of HIV cases. If proposed changes to Medicare Part D are approved, one of the most significant changes that would take effect would be the removal of protected class status of medications used to treat HIV, meaning that patients may not receive the specific medication that would be best for them to fight their condition.
Nina Sublette, PhD, APRN-BC, with the University of Tennessee Health Science Center (UTHSC) Colleges of Nursing and Medicine, recently traveled to Washington, D.C., with a group of health care professionals from across the country to discuss this issue with Assistant Secretary of Health and Human Services Brett Giroir. The group met to converse about the short- and long-term effects new rules could have on patients dealing with everything from cancer to depression.
“HIV is unique,” Dr. Sublette said. “There is a stigma associated with it that is just not there with cancer or diabetes. When people are ashamed and afraid, they often do not seek care for themselves. Barriers to care lead can lead to delayed treatment, which can result in disease progression from HIV to AIDS.”
In 1995, 50,000 people died from AIDS. Now, fewer than 7,000 people die per year. Limiting the kinds of medication covered under Medicare Part D could force patients to rely on medication that doesn’t work or has adverse effects. The changes could also create additional barriers to treatment such as pre-authorization processes.
“Research has shown that HIV testing, immediate access to care, initiation of treatment, and viral suppression is critical,” Dr. Sublette said. “This prolongs life expectancy, improves health and quality of life, and prevents complications from untreated HIV by decreasing HIV viral replication. This process also has an impact on public health and is significant for the prevention of HIV transmission. Once a patient’s HIV is completely suppressed, they cannot transmit it to another person.”
Dr. Sublette, an assistant professor in Health Promotion and Disease Prevention in the College of Nursing and the Department of Obstetrics and Gynecology in the College of Medicine at UTHSC, was nominated to attend the discussion by the Association of Nurses in AIDS Care. She is the chairman of the Policy and Advocacy Committee.