Novartis and Amgen have quietly restricted their entire drug portfolios – more than 300 essential medicines – for patients who live with or are at-risk of getting HIV. It’s a breathtaking misstep from companies that pride themselves on advancing human health, and a move that repeats history in all the wrong ways.
We have seen over and over again throughout history people living with HIV or at-risk of getting HIV be denied the full scope of care they deserve. Until the Affordable Care Act, an HIV diagnosis meant you could be denied health insurance altogether. For years, policies excluded HIV positive women from IVF services. It took a Supreme Court case in 1998 to protect people living with HIV from discrimination against being denied routine dental care. People living with HIV were excluded from cancer and psychiatric drug trials; it required the FDA and NIH to formally update its guidance in 2020 to correct the bias. The practical effect of these exclusions over many decades are why there are federally designated STD specialty clinics and Ryan White clinics in the first place, and where the majority of people living with or at-risk of getting HIV receive their care today.
Now, in 2025, history is rhyming again. Novartis and Amgen said if I live with HIV or take PrEP, and receive care from any clinic that partners with a health department to provide HIV prevention & management services, go somewhere else if you want their medications. Choose between your HIV care or managing your heart disease. Your PrEP or your mental health. HIV or cancer.
There’s a lot of technical and legal jargon behind the scenes on why and how Novartis and Amgen are restricting life-saving medications for people impacted by HIV, but the real effect at the end of the day is this: denial of care. It is completely disingenuous to divert patients elsewhere for their care. “Elsewhere” doesn’t even exist for a lot of these patients.
If I am a patient, I want to go to the doctor that I can fully choose for my care needs. Who understands me and the totality of my health needs. Now, my doctor can’t provide the full scope of care I need on the basis that it offers STD testing services, or provides educational materials from their local health department. If I’m a patient, I now live in a world where I can no longer access medications for my heart condition on the basis that I have HIV or take PrEP.
This is a fully reversible decision; we’ve seen pharmaceutical manufacturers create their own interpretations of 340B statute, adjust, and rescind them.
Many parts of 340B statute are frustratingly grey, which is why safety net providers are subject to the whims of decisions made in board rooms instead of exam rooms. But what is crystal clear, is that this creates a systemic barrier to care for people living with or at-risk of HIV to access the medications they need.
This isn’t on brand or on mission for Amgen and Novartis. It doesn’t offer a solution for making medicines more affordable. It doesn’t even impact their bottom line, as it’s a narrow subset of patients who rely on medicines both from Novartis and mainline HIV drug manufacturers. But there are patients who rely on both for their care, heavily, and they are the ones who bear the life and death consequences of these decisions.
We urge Amgen and Novartis to pull back and reconsider the impact of their decision. Keep essential medicines available for the people who need them most.
