HIV/AIDS: Taming a chronic disease

Over 1.1 million people in the United States are living with HIV. In 2013, 47,352 people in the U.S. were diagnosed with HIV, and 26,668 were diagnosed with AIDS.2 The recommended treatment for HIV —  antiretroviral therapy (ART) — uses a mix of specialty drugs that, taken in combination, can prevent the growth of the virus.

Treatment is available — but not always affordable

Monthly costs for members can range from $2,000 to $5,000.2 Having health insurance goes a long way to making costs manageable for affected people.

In the past, many self-employed and unemployed people fell through the cracks because they couldn’t afford health insurance. Now, the Affordable Care Act (ACA) and its health insurance marketplaces (HIM) give all Americans better access to affordable health insurance. People can’t be denied coverage for pre-existing conditions. And insurers can’t impose lifelong caps on most insurance benefits.

Global developments

Scientists have discovered that if people with the virus take ART as soon as possible after diagnosis they can live relatively normal lives with very little risk of passing the virus to their sexual partners. The World Health Organization issued guidelines in September that urged people to be treated immediately instead of waiting until their immune systems deterioriate.3

Manufacturers have learned to put several ART drugs in a single pill that is taken once a day. This makes treatment easier. Companies are reducing prices for those drugs in countries that cannot pay much, including for a pill that may be less than $100 per person per year.3

World AIDS Day is held on December 1st each year. It is an opportunity for people worldwide to unite in the fight against HIV, show their support for people living with HIV, and commemorate people who have died.

Heightened importance of adherence

Research has shown that adherence to ART helps sustain HIV suppression, reduce risk of drug resistance, improve overall health, quality of life and survival.4,5 It also decreases the risk of HIV transmission.6 Strict adherence to ART is important for good long-term outcome because non-adherence can lead to future drug resistance and loss of future treatment options.7

Prime Therapeutics Specialty PharmacyTM offers coordinated care, specialized education and easy access to experts. These can help members learning about complicated drug regimens and provide support month in and month out.

Members who use Prime Specialty Pharmacy are more adherent compared to those using retail pharmacies, which can lead to improved outcomes. 8 Also, overall member satisfaction has stayed at or above 91 percent for the past eight quarters.9                       

In helping members manage chronic specialty conditions, Prime Specialty Pharmacy can help increase member engagement and adherence — which can lead to better outcomes and lower overall costs.

Next story: Lowering high-risk medicine mishaps

1. “The cost of treating HIV: One Man’s Monthly Medical Bill.” By Adam Wenger.  December 16, 2014. Healthline Networks, Inc.  Accessed at:

2. AIDS Key Facts. World Health Organization. July 2015. Accessed at:

3. An Opening in the War Against AIDS, by the editorial board, New York Times. Dec 2, 2015. Accessed at:

4. Chesney MA. The elusive gold standard. Future perspectives for HIV adherence assessment and intervention. J Acquir Immune Defic Syndr. 2006;43 Suppl 1:S149-155. Available at

5. World Heath Organization (WHO). Adherence to long term therapies—evidence for action. 2003. Available at

6. Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6):493-505. Available at

7. Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents; Limitations to Treatment Safety and Efficacy: Adherence to Antiretroviral Therapy. Clinical Guidelines Portal. May 1, 2014. Aidsinfo.  Accessed at:

8. Prime Specialty Pharmacy study. (1Q2014).

9. Prime Therapeutics Specialty Pharmacy member satisfaction study (2015). 


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