US to roll back coverage of COVID-19 vaccines, treatments starting this fall

The Biden administration is set to begin shifting costs of COVID-19 vaccines and treatments to the commercial market, ending the practice of the U.S. government purchasing the drugs and making them available at no cost, The Wall Street Journal reported Aug. 18.

HHS is set to hold an Aug. 30 planning meeting with representatives from drugmakers, pharmacies and state health departments to discuss the change. Shifting how COVID-19 vaccines, tests and treatments are funded is expected to take months, an agency spokesperson told The Journal

The eventual end to underwriting COVID-19 drugs was always in the cards for the U.S. government under both the Biden and Trump administrations. At an event sponsored by the US Chamber of Commerce Foundation Aug. 16, White House Covid-19 Response Coordinator Ashish Jha, MD, said the administration has been thinking about its move from the "acute emergency phase" of the pandemic in which the government is purchasing vaccines, treatments and diagnostic tests.

"My hope is that in 2023, you're going to see the commercialization of almost all of these products. Some of that is actually going to begin this fall, in the days and weeks ahead. You're going to see commercialization of some of these things," Dr. Jha said.

Vaccines, diagnostic testing and treatments would move closer into the regular U.S. healthcare system under the change. "If you need a treatment, you get a treatment the way you'd get treatments for heart disease and other viruses and bacteria and other kinds of things," Dr. Jha said. 

Top of mind for the administration is ensuring that moving COVID-19 resources into the commercial market does not leave 30 million Americans who are uninsured at a disadvantage. "Right now everybody can walk into CVS and get a vaccine. I want to make sure when we make this transition, we don't end up in a point where nobody can get a vaccine because we didn't get the transition right," Dr. Jha said. 

Health insurers and pharmacy benefit managers will be more involved in negotiating prices with the manufacturers of COVID-19 drugs, with prices likely ending up higher than what the government has paid, likely resulting in premium increases, Larry Levitt, executive vice president for health policy at Kaiser Family Foundation, told The Journal

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