Dear Governor Walz and Commissioner Harpstead,

We write collectively to strongly oppose the MN Department of Human Services Medical Assistance Formulary Committee’s changes to the HIV drug class on October 1st that put in place unnecessary barriers to HIV medications that Minnesota’s most vulnerable depend on for their health. We urge you to use your authority and stop this change.

As community-based service organizations, HIV medical providers, public health professionals, advocates, and people living with HIV, we are determined to fight to end the HIV epidemic. Essential to achieving this goal is ensuring access to critical HIV medications. As our partner in these efforts, we would hope that the State, especially DHS leadership, would understand this need.

We are deeply disappointed that, despite our concerns and those of others who testified, the Drug Formulary Committee would move forward to place five HIV medications on the non-preferred drug list. Doing so not only jeopardizes the health of people living with HIV, but also jeopardizes one of the most effective drugs available to prevent HIV transmission: Descovy. Rapid access to Descovy is used to initiate care for those newly diagnosed with HIV and for those seeking protection from HIV through pre-exposure prophylaxis (or PrEP). Barriers like requiring prior authorization to Descovy will only make it harder to fight HIV.

About one-half of all people living with HIV in Minnesota get their health insurance coverage through Medicaid or the AIDS Drug Assistance Program. People living with HIV who have Medicaid coverage, by virtue of qualifying for the program, are low income and have significant existing barriers to care.

We are disappointed that the Drug Formulary Committee failed to conduct any kind of equity analysis of the potential effects of their decision, especially when we know that HIV disproportionately affects communities of color and LGBTQ communities. At a time when we are working together so vigorously to fight health disparities, access to vital HIV medications should not be made more difficult for the communities most deeply affected by this epidemic

We are disappointed about the lack of transparency and the unclear purpose of the Drug Formulary Committee. No public notice was provided about the Committee’s intent to decide on the HIV drugs to be placed on the non-preferred drug list before the meeting. We were also surprised to hear the Pharmacy Director state that the decision on the HIV class was a “business decision, not a health decision,” when the Committee is comprised of health care professionals appointed to make health care decisions.

Adherence to HIV therapy is essential to accomplishing Minnesota’s END HIV MN plan. The barriers approved by the Drug Formulary Committee will only move us backwards in ensuring the most vulnerable in our state have access to these lifesaving medications. We strongly oppose the proposed changes made to the Medicaid HIV class and we urge you to reject those changes immediately.

Respectfully submitted by the undersigned

Gwen Velez, Executive Director, African American AIDS Task Force Matt Toburen, Executive Director, Aliveness Project Phoebe Trepp, Executive Director, Clare Housing Jason Wachtl, Pharm.D., BCACP, BCGP, Vice President, Geritom Kelly McAnnany, Executive Director, Health Access MN Nick Vogenthaler, MD, MPH, Medical Director of the Positive Care Center, Hennepin Healthcare Susan Palchick, Director of Hennepin County Public Health, Hennepin County Public Health Bill Tiedemann, Executive Director, Hope House Sharon Day, Executive Director, Indigenous Peoples Task Force Jeremy Hanson Willis, CEO, JustUs Health Sarah Rybicki, Director, Midwest AIDS Training + Education Center (MATEC) Monica Meyer, Executive Director, OutFront MN Mary McCarthy, Executive Director, Rural AIDS Action Network Michael Ruppal, Executive Director, The AIDS Institute Val Smith, Executive Director, Youth and AIDS Project

CLINICIANS:

MJ Kasten, MD, FIDSA, HIVMA; Rochester, MN Brian K. Goodroad, DNP, APRN, CNP, FAANP, Hennepin Healthcare Positive Care Center and Midwest AIDS Training and Education Center Daniel Jude, PharmD, AAHIVP, CSP; Clinical HIV Pharmacist Dr. Leslie Baken Christina G (Rivera) O’Connor, PharmD, RPH, BCPS, AAHIV-P Deanna Scherr, L.I.C.S.W., M.S.W. HIV clinic social work Melissa Saftner PhD, CNM, Clinical Professor School of Nursing, University of Minnesota Ryan Kelly, MD, University of Minnesota Zach Kaltenborn, MD, University of Minnesota/Minnesota Community Care Melanie Nicol, PharmD, PhD, University of Minnesota College of Pharmacy Lisa C. Lynch Jones NP, Park Nicollet/Health Partners William Sharp, APRN, CNP, AAHIV specialist Ann M. Philbrick, PharmD, FCCP, BCPS, BCACP, University of Minnesota Kristen Gamache, PharmD, BCPS, AAHIVP, Positive Care Center HCMC Keith Henry, MD, Hennepin County Medical Center/Positive Care Clinic Calla Brown, MD, MHR; Principal Investigator, Youth and AIDS Projects Charles Howald PharmD, AAHIVP, Walgreens George Froehle PA-C, AAHIVS Kari Rabie, MD, CMO, Native American Community Clinic Dr. S. Rebecca Peglow, HealthPartners Infectious Diseas