MEDICARE EXPANDS COVERAGE FOR TREATING FACIAL LIPODYSTROPHY SYNDROME IN
PEOPLE LIVING WITH HIV
On March 23, 2010, the Centers for Medicare & Medicaid
Services (CMS) announced its decision to cover facial injections for
Medicare beneficiaries who experience symptoms of depression due to the
stigmatizing appearance of severely hollowed cheeks resulting from the
drug treatment for Human Immunodeficiency Virus (HIV). This decision is
effective immediately.
Facial lipodystrophy (LDS) is a localized loss of fat from
the face, causing an excessively thin appearance in the cheeks. In some
cases, facial LDS may be a side effect of certain kinds of medications
(antiretroviral therapies) that individuals receive as part of an HIV
infection treatment regimen.
The facial LDS can leave people living with HIV looking
gaunt and seriously ill, which may stigmatize them as part of their
HIV-infection status. Individuals who take these medications and
experience facial LDS side effects may suffer psychological effects
related to a negative self-image. These effects may lead people living
with HIV to discontinue their antiretroviral therapies. The new
decision allows for treatment of individuals who experience symptoms of
depression due to the appearance changes from facial LDS.
The injections included in this coverage decision are "fillers" that
have been approved by the U.S. Food & Drug Administration (FDA) to be
injected under the skin in the face to help fill out its appearance
specifically for treatment of facial LDS. Data show that these
injections can improve patient self-image, relieve symptoms of
depression, and may lead to improved compliance with anti-HIV treatment.
"Today's decision marks an important milestone in Medicare's
coverage for HIV-infection therapies," said Barry M. Straube, M.D., CMS
Chief Medical Officer and Director of the Agency's Office of Clinical
Standards & Quality. "Helping people living with HIV improve their
self-image and comply with anti-HIV treatment can lead to better quality
of life and, ultimately, improve the quality of care that beneficiaries
receive."
The final decision is posted on the CMS Website at
http://www.cms.hhs.gov/mcd/viewdecisionmemo.asp?id=234.
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