FPC NEGOTIATES FOR PATIENT ASSISTANCENelson Vergel
Lynda Dee: 410-332-1170
Fair Pricing Coalition
FPC NEGOTIATES FOR PATIENT ASSISTANCE AND CO-PAY PROGRAMS
Washington, DC, April 1, 2009 – The Fair Pricing Coalition (FPC), which was founded by the late Martin Delaney of Project Inform, is a national coalition of activists who work on HIV drug pricing issues and who help control drug costs, thereby insuring access for recipients of state AIDS Drug Assistance Programs (ADAPs), Medicare and Medicaid, and patients who are privately insured, underinsured and uninsured.
The FPC has recently negotiated with all major HIV drug manufacturers to require them to institute patient drug co-pay programs. The new drug co-pay programs are a direct result of intense work and negotiations between the FPC and representatives of the pharmaceutical industry.
Most, if not all, HIV pharmaceutical companies already provide some level of patient assistance to individuals who are unable to afford their HIV medications. Several companies have also recently instituted co-pay assistance programs, which may cover all or part of the drug co-pay for many privately insured patients, up to a specified amount, and for a pre-determined period of time, for example, up to one year. Certain restrictions and eligibility requirements apply. For example, ADAP, Medicare and Medicaid patients are ineligible for co-pay programs. Eligibility requirements may vary from program to program. Once eligibility is determined, most companies will then provide patients with a co-pay card which can be presented to a pharmacist or a mail order pharmacy when filling your prescription. Since the FPC expects the launch of new programs and revisions in current programs as negotiations continue, patients should contact or ask their health care providers or pharmacies to contact drug manufacturers directly for updated details on a specific drug.
Jeff Berry, Editor of Positively Aware, Chicago, IL and FPC member states â€œIn our current economic crisis and with the continued rising costs associated with health care, these new programs offer much needed assistance to people who may have insurance but who can not afford to pay the ever rising cost of their monthly prescription co-pays.â€
Below is a brief description of most HIV drug co-pay programs:
Abbott: Positive Partnership PLUS Card. Abbott recently launched a pilot program that expands the Positive Partnership Card. This 12 month program covers Kaletra plus other ARVs and requires no income or co-pay eligibility requirements. Your first out of pocket dollar will be covered up to a maximum of $50 for Kaletra each month. Abbott will also cover another $50 monthly for each additional HIV prescription up to a limit of $100 monthly. The FPC is extremely disappointed that Norvir is currently not part of this program. Visit www.kaletra.com for more information.
Bristol-Myers Squibb (BMS) recently announced that they will be launching a co-pay program in April of 2009. Their program will include Reyataz and Sustiva. More details will be provided as they become available. We hope Atripla, the one pill once a day, which BMS co-manufacturers with Gilead will be covered in the BMS program.
GlaxoSmithKline (GSK): Patient Savings Card. The GSK program is the most patient-friendly, covering the entire amount of all your actual out-of-pocket cost up to a maximum of $100 for each prescription. All GSK HIV drugs are covered, including Combivir, Epivir, Epzicom, Lexiva, Retrovir, Trizivir, and Ziagen. Visit www.mysupportcard.com for more information and to print the card.
Gilead: Truvada Co-pay Assistance Program. Gilead’s program covers Truvada, Emtriva, and Viread. This program covers only high co-pays and kicks in only once patients have spent over $50 in out-of-pocket costs and covers a maximum of $200 in co-pays per month. Patients or providers can call toll-free 1-888-358-0398 to receive an eligibility card from Gilead by mail. Atripla is currently not part of this program.
Merck: Unfortunately, Merck does not have a specific insurance co-pay assistance program. However, it does have a patient assistance program for Isentress and Crixivan called â€œSupport.â€ If patients need co-pay assistance for Crixivan or Isentress they need to use the Support program. Call 1-800-850-3430, or visit www.isentress.com, click on the site map, and then click Support. Patients have experienced difficulty in accessing the co-pay aspect of this program.
Pfizer: The FPC is also disappointed that Pfizer does not offer co-pay assistance for any of its HIV medications. It does provide reimbursement assistance, appeals assistance, and patient assistance for Selzentry, Viracept and Rescriptor. Pfizer also offers information on obtaining assistance with tropism testing. Call the Pfizer RSVP program at 1-888-327-RSVP (7787).
Tibotec: Tibotec Therapeutics Patient Savings Program. Tibotec covers Prezista and Intelence. This program covers 80% of the amount of your actual out-of-pocket cost up to $100 per drug per month. Visit www.prezista.com/prezista/patient_assistance.html or call toll-free 1-866-961-7169
# # #