CIGNA, one of the nation’s largest health insurers, ended a requirement that patients across the United States obtain their HIV/AIDS medications by mail-order under a settlement of a class action lawsuit announced in October 2015.
The lawsuit, JOHN DOE v. CIGNA, was filed by Whatley Kallas, LLP, Consumer Watchdog—a non-profit consumer group—and Podhurst Orseck P.A., and presided over by United States District Court Judge Darrin Gayles in Broward County, Florida.
Due to the complex nature of HIV/AIDS drug regimens, patients rely on their local pharmacists who, working directly with patients, monitor potentially life-threatening adverse drug interactions and side effects. Pharmacists also provide essential advice and counseling that help HIV/AIDS patients and families navigate the challenges of living with a chronic and often debilitating condition.
HIV/AIDS patients also expressed serious concerns about a loss of privacy associated with mail-order. For example, HIV/AIDS specialty medications often are delivered in refrigerated containers. Patients who live in apartment buildings or have medications delivered to their work place have expressed alarm that neighbors, co-workers, and employers, who do not know that the recipient has HIV/AIDS, would come to suspect that they are seriously ill.
Under the settlement, patients with HIV or AIDS may obtain their antiretroviral HIV/AIDS medications from any in-network retail pharmacy beginning December 1, 2015 (January 1, 2016 for individual and small group plans). In addition, patients who paid more for their prescriptions as result of the mail-order requirement may seek reimbursement of their out-of-pocket costs.
“This settlement brings to a close a nerve-racking episode for patients with HIV and AIDS who face serious threats to their health and privacy,” said Jerry Flanagan, lead staff attorney for Consumer Watchdog.
Whatley Kallas, LLP and Consumer Watchdog have settled two similar suits against United Healthcare and Anthem Blue Cross. Under those settlements, HIV/AIDS patients have a right to opt-out of those companies’ mail-order program.
Download the settlement agreement here.