今天，美国卫生和公众服务部宣布了一项计划，向没有保险的人免费提供艾滋病毒预防药物。
暴露前预防，或称PrEP，是艾滋病毒感染者唯一的预防治疗方法，但在美国，这是出了名的昂贵，尤其是对于那些有高免赔额健康计划或没有保险的人。
唐纳德·特朗普总统在2030年结束美国艾滋病疫情的战略的第一阶段。HHS官员周二表示，从不迟于2020年3月开始，人们可以在超过21，000个综合诊所、沃尔格林诊所和Rite Aid诊所获得PrEP药物——这些公司捐赠了他们的服务，以“认识到”扩大PrEP服务的重要性新闻稿。
疾病控制和预防中心(CDC)2018年的一项分析显示，去年有38，000多名美国人新感染了艾滋病毒，但“只有一小部分”易受病毒感染的人使用PrEP。
HHS国务卿阿历克斯·阿扎尔在接受记者采访时说，该计划将被理解为21世纪的主要公共卫生举措之一。该部门估计，每年南方有200，000人容易感染艾滋病毒且没有保险，他们可以从该计划中受益。
贾勒德科学公司正在提供这种药物，作为其3月份与HHS协议的一部分，尽管它与联邦卫生部门仍有法律纠纷。直到2030年，该公司每年捐赠足够20万人使用的药物，这涵盖了HHS项目的潜在范围。
11月，HHS起诉贾里德侵犯了与PrEP相关的美国专利。据HHS报道，该公司以每年20，000美元的高价出售唯一一种美国食品和药物管理局批准的PrEP疗法通告当时。
为了有资格参加这个项目，病人必须通过实验室测试来检测艾滋病毒阴性，他们可能要为此付费。他们还需要医生的处方。
根据约翰霍普金斯彭博公共卫生学院2015年公布的一项调查，如果没有保险，看初级保健医生大约需要160美元，各州之间会有所不同。HHS说，人们可以通过访问GetYourPrEP.com或拨打免费电话855-447-8410来了解自己是否合格。
对于有保险但免赔额很高的人来说，PrEP在2030年左右之前可能仍然太贵，那时Azar说这些药物在美国有资格获得仿制药，因此会变得更便宜。
疾病预防控制中心估计，超过100万美国人有感染艾滋病毒的风险，但2015年，商业药店总共只开了9万张PrEP处方。
疾控中心表示，在同一年，50万黑人居民和30万拉丁美洲居民可以从治疗中受益，但零售药店和邮购服务机构分别只开了7000张和7600张处方。对于白人来说，300，000人本可以从中受益，但只开了42，000张处方。
美国食品和药物管理局(FDA)代理专员布雷特·吉尔洛在一份声明中说:“如果按照指示服用，PrEP在预防艾滋病毒感染方面非常有效。”。“它是结束艾滋病毒流行的一个重要工具，但要产生影响，它必须提供给最需要它的人。”
TRUMP ADMINISTRATION ANNOUNCES FREE HIV-PREVENTION MEDICATION FOR UNINSURED AMERICANS
Today, the U.S. Department of Health and Human Services announced a plan to make HIV prevention medication free to people without insurance.
Pre-exposure prophylaxis, or PrEP, is the lone prevention treatment for people susceptible to HIV infection, but it's notoriously expensive in the United States, especially for people on high-deductible health plans or without insurance.
It's phase one of President Donald Trump's strategy to end the United States' HIV epidemic by 2030. Starting no later than March 2020, people can obtain the PrEP medications at more than 21,000 combined CVS Health, Walgreens and Rite Aid locations—companies that donated their services in "recognizing the importance" of expanded PrEP access, HHS officials said in Tuesday's press release.
More than 38,000 Americans were newly infected with HIV last year, but "only a small percentage" of people susceptible to the virus use PrEP, according to a 2018 analysis by the Centers for Disease Control and Prevention (CDC).
In a call with reporters, HHS Secretary Alex Azar said the plan will be understood as one of the major public health initiatives of the 21st century. The department estimates that somewhere south of 200,000 people each year, who are susceptible to HIV infection and uninsured, could benefit from the program.
Gilead Sciences is supplying the medication as part of its March agreement with HHS despite its ongoing legal disputes with the federal health wing. Now until 2030, the company is donating enough medication to supply 200,000 individuals annually, which covers the potential reach of the HHS program.
In November, HHS sued Gilead for infringing on U.S. patents related to PrEP. The company sells the only FDA-approved PrEP regimen at the lofty sticker price of $20,000 per year, according to the HHS announcement at the time.
To qualify for the program, patients must test negative for HIV through a lab test they will likely have to pay for. They also need a prescription from a doctor.
Without insurance, a visit to a primary care doctor is about $160, with some variation among states, according to a 2015 survey published by the Johns Hopkins Bloomberg School of Public Health. People can find out if they qualify by visiting GetYourPrEP.com or calling toll-free 855-447-8410, HHS said.
For people with insurance, but subject to high deductibles, PrEP could remain too costly until about 2030, when Azar said the drugs are eligible for generic copies in the U.S., and will therefore become cheaper.
The CDC estimates that more than 1 million Americans are at-risk for HIV, but only 90,000 total PrEP prescriptions were filled in commercial pharmacies in 2015.
In the same year, 500,000 black residents and 300,000 Latino residents could have benefited from the treatment, but only 7,000 and 7,600 prescriptions were filled by retail pharmacies and mail-order services, respectively, the CDC said. For white people, 300,000 could have benefited, but just 42,000 prescriptions were filled.
"PrEP is highly effective in preventing HIV infection when taken as directed," said Brett P. Giroir, the acting commissioner of the U.S. Food and Drug Administration (FDA), in a statement. "It is a critical tool for ending the HIV epidemic, but to make an impact it has to be available for people who need it most."
