Congressmembers call on task force to require insurers to cover doxy PEP

More than a dozen congressmembers are fighting to require health insurance companies to provide the STI prevention medication doxy PEP without any extra costs for patients.

Doxy PEP, an antibiotic taken within 72 hours of sex to prevent STIs such as chlamydia, gonorrhea, and syphilis, has been emerging as a tool in the fight against STIs in light of data from the Centers for Disease Control and Prevention (CDC) showing a 74% increase in syphilis cases and 28% rise in gonorrhea from 2017 to 2021. 

Calif. Congressmembers Barbara Lee and Robert Garcia, who is gay, penned a letter signed by 16 lawmakers — including out lawmakers Mark Pocan of Wisconsin and Becca Balint of Vermont — urging the US Preventive Services Task Force to issue an A-grade rating recommendation for the use of doxy PEP among the most affected populations. The rating would, in accordance with the Affordable Care Act, require insurers to cover the costs of the medication without cost sharing. The Aug. 8 letter was first covered by the Washington Blade.

In early June of this year, the CDC issued final guidelines calling on doctors to discuss doxy PEP with gay, bisexual, and other men who have sex with men and transgender women who have had at least one bacterial STI in the last year. The CDC also said doxy PEP could be discussed with those populations if individuals express plans to participate in riskier sexual activities.

“As you know, STI prevention and care depends on access to screening and contact with the healthcare system and was severely disrupted by the COVID-19 pandemic,” explained the letter, which was addressed to members of the US Preventive Services Task Force as well as its chair, Dr. Wanda Nicholson. “As with HIV, this epidemic disproportionately impacts both LGBTQIA+ Americans and communities of color, and addressing it requires not only a reinvestment in these efforts but new approaches to preventive care.”

The letter noted that the US Preventive Services Task Force previously gave an A-grade recommendation for PrEP, which broadened access to the medication and led to 150,000 additional people taking PrEP between 2019 and 2022.

“As with recent HIV prevention efforts through PrEP, we believe this implementation must start with a formal recommendation and ‘A’ rating from USPSTF to ensure Americans who can benefit from doxy PEP have access to the treatment at no additional cost though Medicaid or private insurance,” the letter added.

Last November, the New York City Department of Health and Mental Hygiene issued a letter to healthcare providers recommending doxy PEP to prevent bacterial STIs. Other cities, including San Francisco, have also moved to make similar recommendations.