Most Large Insurance Companies Have Agreed To Cover AIDS Drug Fuzeon, Trimeris CEO Says
Approximately 94% of the 142 largest insurance companies, including Aetna and Cigna, have agreed to cover Roche's new antiretroviral drug Fuzeon despite its high cost, according to Dani Bolognesi, CEO of Trimeris, the biotechnology company that developed the drug in partnership with Roche, the Raleigh News & Observer reports. In addition, 48 state Medicare programs have agreed to cover Fuzeon, according to Bolognesi (Ranii, Raleigh News & Observer, 5/14). The FDA on March 13 approved the drug, which is designed for HIV/AIDS patients who have failed to respond to other medications and is the first drug in seven years that uses a new method to fight HIV. Roche, the Swiss pharmaceutical company producing and marketing the drug, and Trimeris in March announced that the price of Fuzeon in the United States would be just under $20,000 per patient per year. The price is double that of the most expensive HIV treatments currently on the market, and because the drug must be taken in combination with other medicines, the total cost of treatment could reach between $30,000 and $40,000 per patient per year (Kaiser Daily HIV/AIDS Report, 4/16). Roche and Trimeris have said that Fuzeon's cost is justified because of the high manufacturing costs and the $600 million that was spent on developing the drug, according to the News & Observer. However, there is concern that "cash-strapped" state AIDS Drug Assistance Programs, which provide antiretrovirals to uninsured HIV patients, will not be able to cover Fuzeon's cost (Raleigh News & Observer, 5/14). ADAP representatives from eight states in March came to an agreement with Roche over pricing for Fuzeon (Kaiser Daily HIV/AIDS Report, 4/24). Currently 13 ADAPs have agreed to cover Fuzeon, but many have had to restrict patient access to the drug or establish waiting lists, according to the News & Observer. Walter Capone, vice president of commercial operations for Trimeris, said he expects almost half of the nation's state ADAPs to cover Fuzeon within the new few months (Raleigh News & Observer, 5/14).This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.