HIV Advocates Condemn Mandatory Mail-Order Programs for Life-Saving HIV Treatment

The Center for Health Law and Policy Innovation of Harvard Law School and 23 other organizations submitted an amicus brief to the Supreme Court of the United States highlighting harmful impacts of mandatory mail-order pharmacy programs. 

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With an estimated 1.2 million people living with HIV in the United States, access to antiretroviral therapy remains a vital component of individual HIV care and broader public health goals to end the HIV epidemic.  Unfortunately, many health plans are requiring people living with HIV to receive their HIV drugs only through mandated mail-order pharmacy programs. As pointed out in an amicus brief submitted to the Supreme Court on Friday, mandatory mail-order pharmacy programs for HIV drugs present problematic issues with privacy, timeliness, and safety, and disrupt the connections that people living with HIV have with key providers and other related services.

The amicus brief was filed by the Center for Health Law and Policy Innovation of Harvard Law School (CHLPI) and 23 other HIV advocacy organizations, health care systems, and medical professional associations. The respondents in the case, CVS v. Doe, are individuals living with HIV who allege that CVS’ mandatory mail-order pharmacy program for specialty medications (including HIV drugs) violates key anti-discrimination provisions.  The plaintiffs argue that mandatory mail-order programs have a disproportionate negative impact on people living with HIV. 

“Timely and safe access to prescription drugs is critical for people living with HIV,” said Maryanne Tomazic, a clinical instructor for CHLPI. “People living with HIV should not be forced to assume the risks associated with mail-order pharmacies, especially when those risks compromise access to life-saving antiretroviral therapy. Together with our co-signatories, we submitted an amicus brief to amplify the perspectives of people living with HIV, providers, and advocates to ensure those voices are on the record in CVS v. Doe.”

The amicus brief raises multiple concerns about mandatory mail-order pharmacy programs. Patient privacy is cited as a major problem that places patients at an increased risk of facing stigma, discrimination, and violence. Advocates also note that delays in the mail delivery system and failure to meet critical temperature requirements for medications could have significant impacts on people’s ability to adhere to their prescribed treatment regimen.

In addition to threatening individual health outcomes, advocates note that mandatory mail-order pharmacy programs stand in the way of the United States’ public health goals to end the HIV epidemic.

“Ensuring timely access to affordable HIV treatment is a core pillar of the federal government’s Ending the HIV Epidemic in the United States Plan,” said Robert Greenwald, faculty director for CHLPI. “Policies and programs that delay access to HIV treatment not only have a disproportionate impact on health outcomes for people living with HIV, but they also undermine our country’s own initiative to end the HIV epidemic. We hope that the courts will stand on the side of justice for HIV communities and patients living with other serious and chronic health conditions who will also be disproportionately harmed by mandatory mail-order programs.”

The Center for Health Law and Policy Innovation submitted the amicus brief with 23 other organizations: ADAP Educational Initiative Columbus, OH; AIDS Action Baltimore; AIDS Alabama; AIDS Foundation Chicago (AFC); AIDS Law Project of Pennsylvania; American Academy of HIV Medicine; American Medical Association, APLA Health; Equitas Health; Fenway Health; HIV Medicine Association; Human Rights Campaign; International Association of Providers of AIDS Care; Legacy Health; North Carolina AIDS Action Network; Prism Health North Texas; San Francisco AIDS Foundation; SisterLove, Inc.; The AIDS Institute; Treatment Action Group; Whitman Walker Health; Whitman Walker Institute; and Vivent Health.