Hoylman’s Rx: NY Senate Pushes For COVID Antiviral Coverage

January 23, 2024

Today, New York State Senator Brad Hoylman-Sigal introduced a bill to make oral antiviral treatments for COVID, such as Paxlovid, free for all New Yorkers covered by Medicaid or private insurance.

On November 1st, 2023 the federal government ended its policy of providing universal access to free COVID-19 treatments. Though Paxlovid, the most commonly used oral antiviral to treat COVID, will continue to be free through 2024 for those with Medicare and Medicaid, some New Yorkers with private insurance are facing high out-of-pocket expenses to get the drug.

While Pfizer offers co-pay assistance to the privately insured to offset the steep $1,390 cost of the medication, patients could still be stuck with a co-pay of as much as $140 for the prescription.

This law would require insurance companies doing business in New York State to cover the full cost of these life-saving medications and chart a path for long-term affordability for Medicaid patients, ensuring that New Yorkers do not needlessly suffer due to the cost of this medication.

Senator Hoylman-Sigal said, “Paxlovid is a life-saving medication that has been shown to reduce the rates of serious illness and death from COVID by as much as 89 percent. Pricey co-pays and high deductibles should not be a barrier to New Yorkers accessing effective treatment. This bill will require private insurers and Medicaid to cover Paxlovid and other oral antivirals at no cost to the insured.”

“… COVID can still be life-threatening … for vulnerable populations …”

The senator continues, “Though it may feel like the pandemic is over, COVID can still be life-threatening, especially for vulnerable populations, and we need to do everything we can to save lives and keep patients out of the hospital. Ensuring that all New Yorkers continue to have free and easy access to highly effective medications that they can take from the comfort of their own homes will do just that.”

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