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April 16, 2018

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Today’s therapies are awfully bigger over the aboriginal drugs acclimated to amusement HIV, but these advancements appear at a cost. The prices of HIV drugs abide to acceleration every year at an boilerplate of 7-9 percent. While in the accomplished these increases usually haven’t anon afflicted addition who has biologic advantage through their bloom allowance plan, added individuals accept to pay co-insurance (a allotment of the bulk of the medication). The acceptable account is that advice is out there. ADAPs, several non-profit organizations, and the biologic companies accept abetment programs in abode to advice you pay for the analysis you need.

The bad account is that changes may be on the way for consumers, as some big bloom insurers no best acquiesce the bulk of the co-pay cards to be activated appear their deductible or abroad maximum, or beacon them appear added cost-containing measures such as footfall analysis or alone generics that breach up an STR.

A cost-sharing abetment affairs (CAP) is a affairs operated by biologic companies to action cost-sharing abetment (including deductibles, co-payments and co-insurance) to bodies with clandestine bloom allowance to admission HIV drugs at the pharmacy.

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A accommodating abetment affairs (PAP) is a affairs run through biologic companies to accommodate chargeless or bargain medications to bodies with low-incomes who do not authorize for any added allowance or abetment programs, such as Medicaid, Medicare, or AIDS Biologic Abetment Programs (ADAPs). Anniversary alone aggregation has altered accommodation belief for appliance and acceptance in their accommodating abetment program.

HarborPath, a non-profit alignment that helps uninsured individuals alive with HIV accretion admission to brand-name decree medicines at no cost, operates a appropriate accommodating abetment affairs for individuals on ADAP cat-and-mouse lists. An alone is acceptable for the HarborPath ADAP cat-and-mouse account affairs alone if he or she has been accounted acceptable for ADAP in his or her accompaniment and is absolute to be on an ADAP cat-and-mouse account in that state.

In 2012, the Department of Bloom and Human Services (DHHS), forth with seven biologic companies, the Civic Alliance of Accompaniment and Territorial AIDS Directors (NASTAD), and association stakeholders developed a accepted accommodating abetment affairs appliance anatomy that can be acclimated by both providers and patients. This anatomy combines accepted advice calm on anniversary alone companies anatomy to acquiesce individuals to ample out one form. Once the anatomy is completed, case managers or individuals again abide the distinct anatomy to anniversary alone company, abbreviation the all-embracing bulk of paperwork all-important to administer for a accommodating abetment program.

HarborPath operates as a streamlined, online aperture for PAP access. HarborPath creates a distinct abode for appliance and medication fulfillment. This “one stop shop” aperture provides a streamlined, online action to authorize individuals and bear the donated medications of the accommodating biologic companies through a mail-order pharmacy.

Special acknowledgment to NASTAD’s Britten Pund and Amanda Bowes for abundant of the advice listed actuality and to Tim Horn for his review. Adapted from HIV Biologic Aggregation HIV Accommodating Abetment Programs and Cost-Sharing Abetment Programs: bit.ly/1XIahvN

DRUGS COVERED

MANUFACTURER & CONTACT INFORMATION

ASSISTANCE

RENEWAL

Kaletra and Norvir

AbbVie 

800-441-4987,

option 5;kaletra.com;

norvir.com

Kaletra: Co-payment abetment covers the aboriginal $400 per decree per month. Norvir: Covers up to $1,200 a year for co-payments.

Reapply anniversary year

Evotaz, Reyataz, and Sustiva

Bristol-Myers Squibb 888-281-8981;bmscustomerconn

ect.com/bms3assist

Evotaz, Reyataz, and Sustiva: Up to $7,500 annually for co-payments, deductibles, and co-insurance in all commercially-insured plans.

Reapply anniversary year

Atripla, Biktarvy, Complera, Descovy, Emtriva, Genvoya, Odefsey, Stribild, Truvada, and Tybost

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Gilead Sciences                   877-505-6986;gileadadvancingacc

ess.com

Genvoya: Covers the aboriginal $7,200 per year of co-payments. Atripla, Complera, Odefsey, and Stribild: Covers the aboriginal $6,000 per year of co-payments. Descovy and Truvada: Covers the aboriginal $4,800 per year of co-payments.Emtriva: Covers the aboriginal $300 per month/$3,600 per year of co-payments. Tybost: Covers the aboriginal $50 per month/$600 per year of co-payments.

Reapply anniversary year

Edurant, Intelence, Prezista, and Prezcobix

Janssen Therapeutics                  866-961-7169;edurant.com; intelence.com;prezista.com; prezcobix.com

Covers the aboriginal $7,500 per year of co-payments, deductibles, and co-insurance.

Reapply anniversary year

Isentress and Isentress HD

Merck and Co.                              800-850-3430;isentress.com

Covers the aboriginal $6,800 per year of co-payments, deductibles, and co-insurance for anniversary of 12 acceptable prescriptions.

Enrollment is accurate until advertisement expires

Juluca,

Lexiva, Rescriptor, Selzentry, Tivicay, Triumeq, and Viracept

ViiV Healthcare                              844-588-3288;ViiVconnect.com

Juluca, Tivicay and Triumeq: $6,000 per year/per accommodating maximum. Lexiva, Rescriptor, Selzentry and Viracept: $2,400 per year/per accommodating maximum.

Automatic renewal

Invirase and Viread

Patient Access

Network Foundation 

866-316-7263;panfoundation.org

Maximum account is $3,600 per year. Patients may administer for a additional admission during their accommodation aeon accountable to availability of funding.

Reapply anniversary year

DRUGS COVERED

MANUFACTURER AND CONTACT INFORMATION

FINANCIAL ELIGIBILITY

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Kaletra, Norvir

AbbVie

800-222-6885;kaletra.com; norvir.com; abbviepaf.org

Kaletra: 500% FPL Norvir: No assets limits

Aptivus, Viramune XR

Boehringer Ingelheim

800-556-8317; rxhope.com; pparx.org

500% FPL

Evotaz, Reyataz, and Sustiva

Bristol-Myers Squibb

888-281-8981;bmscustomerconnect.com/bms3assist

300-500% FPL

Atripla, Complera, Descovy, Emtriva, Genvoya, Odefsey,Stribild, Truvada, Tybost, and Viread

Gilead Sciences*

866-290-4767;gileadadvancingaccess.com

500% FPL

Edurant, Intelence,Prezista, and Prezcobix

Janssen Therapeutics

800-652-6227; jjpaf.org

300% FPL

Crixivan, Isentress, and Isentress HD

Merck and Co.

800-727-5400;merck.com/merckhelps; isentress.com

500% FPL

Combivir, Epivir, Epzicom, Lexiva, Juluca, Rescriptor, Retrovir, Selzentry, Tivicay, Triumeq,Trizivir, Viracept, and Ziagen

ViiV Healthcare

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844-588-3288;ViiVconnect.com

500% FPL

* Patients who are insured and who do not accommodated their payer’s advantage belief are no best acceptable for abutment via Gilead’s accommodating abetment program. This includes audience whose insurer has bound admission based on: step-therapy or analytic belief (e.g., biologic and booze testing).

Pre-exposure prophylaxis (PrEP) is the use of antiretroviral (ARV) medication to anticipate accessible HIV manual with HIV-negative individuals who may be at college accident of infection. PrEP is currently recommended for ually alive men who accept with men (MSM), heteroual men and women, and intravenous biologic users (IDU). Additional advice on PrEP is accessible on the U.S. Centers for Disease Control and Prevention (CDC) website.

As of Feb. 9, 2018, Truvada is the alone ARV accustomed by the U.S. Food and Biologic Administration for use as PrEP.

PrEP Accommodating Abetment Affairs (PAP)

PrEP Cost-sharing Abetment Affairs (CAP)

Post-exposure prophylaxis (PEP) involves demography antiretroviral (ARV) medicines actual anon afterwards a accessible acknowledgment to HIV to anticipate acceptable adulterated with the virus. PEP should be started as anon as accessible to be able and consistently aural 72 hours (3 days) afterwards a accessible acknowledgment to HIV. If your bloom affliction provider thinks PEP is appropriate for you, you’ll booty 3 or added ARV medicines every day for 28 days.

Contact your affliction provider or bounded AIDS account alignment for advice accepting started. Clinicians can alarm the civic PEP hotline at (888) 448-4911 for able guidance, or go to nccc.ucsf.edu/clinician-consultation/pep-post-exposure-prophylaxis. Additional advice on PEP is accessible at the HIV Analytic Guidelines Affairs and on the CDC website.

NOTE: Some of these medications are recommended for PEP alone beneath assertive conditions. The best frequently recommended dieting for PEP is Truvada additional Isentress or Tivicay.

CAPs and PAPs are accessible for PEP, but anniversary aggregation has altered behavior for applying and commitment of medications. See abundant instructions for anniversary biologic aggregation beneath and on the afterward page.

DRUGS COVERED

MANUFACTURER AND CONTACT INFORMAITON

ASSISTANCE

Kaletra

AbbVie

800-222-6885;kaletra.com

The cost-sharing abetment covers the aboriginal $200 per Kaletra prescription.

Reyataz

Bristol-Myers Squibb

888-281-8981;bmscustomerconnect.com/bms3assist

The affairs covers up to $7,500 annually for co-payments, deductibles, and co-insurance in all commercially-insured affairs for Reyataz.

Emtriva,

Truvada

Gilead Sciences

877-505-6986;gileadadvancingaccess.com

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Truvada: Covers the aboriginal $4,800 per year of co-payments.Emtriva: Covers the aboriginal $300 per month/$3,600 per year of co-payments.

Prezista

Janssen Therapeutics

800-652-6227;jjpaf.org

Co-payment abetment starts afterwards the aboriginal $5 paid by the consumer, again absolute co-payment coverage.

Isentress

Merck and Co.

800-850-3430;isentress.com

Covers the aboriginal $400 per ages of co-payments.

Epivir, Lexiva, and Tivicay

ViiV Healthcare

844-588-3288; 

viivconnect.com

Covers up to $200 of co-payment on anniversary ViiV prescription, except Tivicay. For Tivicay, the affairs covers the aboriginal $400 per-month of co-payments.

DRUGS COVERED

MANUFACTURER AND CONTACT INFORMATION

FINANCIAL ELIGIBILITY

ACCESS INFORMATION

Kaletra

AbbVie

800-222-6885;kaletra.com

500% FPL

1. Complete an application; advertence TRAUMA on the appliance (this will accelerate processing). 2. Fax to: 732-584-0905. 3. Alarm AbbVie, acquainted that you beatific a fax for a TRAUMA case. 4. AbbVie will accelerate medications to provider. If accustomed by 12:30 PM, will accept brief commitment (about 24 hours). If accustomed afterwards 12:30 PM, will accept aing day commitment (about 48 hours).

Reyataz

Bristol-Myers Squibb

888-281-8981;bmscustomerconne

PAZEO DROPS - pay as little as $13 (limits may apply) | Pharmacy ..
PAZEO DROPS – pay as little as $13 (limits may apply) | Pharmacy .. | stribild copay card

ct.com/bms3assist

300-500% FPL

1. Complete an application; advertence POST EXPOSURE on the appliance (this will accelerate processing). 2. Fax to: 1-888-281-8985. 3. Alarm Bristol-Meyers Squibb, acquainted that you beatific a fax for a POST EXPOSURE case. 4. Bristol-Meyers Squibb will accelerate medications to provider or patient. Medications are alien overnight, except on Fridays.

Emtriva, Truvada, and Viread

Gilead Sciences

877-505-6986;gileadadvancingacc

ess.com

500% FPL

1. Fax a letter of medical alarm to 1-800-226-2056, including: patient’s name, analysis needed, date of exposure, provider’s signature. 2. Alarm Gilead at 1-800-226-2056 and acquaint them you accept a accommodating who needs PEP Monday – Friday, 9am – 8pm EST.). Tell them you faxed a letter of medical necessity. Accord them time of fax, cardinal of pages, your fax number. Accept the patient’s advice available: name, address, buzz number, date of birth, Social Security number, cardinal of bodies claimed as dependents, domiciliary income, any allowance coverage, provider name, provider address, provider buzz number, and parental/guardian signature of accord for any accommodating beneath 18 years of age. 3. Gilead Sciences will accord you a agenda cardinal to abode on the prescription. The accommodating may go to the pharmacy to ample the decree with no abroad expense.

Prezista

Janssen Therapeutics

800-652-6227;jjpaf.org

200% FPL

1. Complete an application, selecting PHARMACY CARD on the application. 2. Fax to: 1-888-526-5168. 3. Alarm Janssen Therapeutics 1 to 2 hours afterwards sending the fax to accept pharmacy agenda number. Write the cardinal on the prescription. The accommodating may go to the pharmacy to ample the decree with no abroad expense.

Isentress

Merck and Co.

800-850-3430;merckhelps.com

500% FPL

1. Complete an application; advertence PRESCRIBING PEP on the appliance (this will accelerate processing). 2. Fax to: 1-866-410-1913.3. Alarm Merck, acquainted that you beatific a fax for PRESCRIBING PEP.4. Merck will accelerate medications to provider. If accustomed by 12:30 PM (PST), will accept brief commitment (about 24 hours). If accustomed afterwards 12:30 PM (PST), will accept aing day commitment (about 48 hours).

Epivir, Lexiva, Tivicay

ViiV Healthcare

844-588-3288;viivconnect.com

500% FPL

Call ViiV Healthcare, advertence IMMEDIATE ACCESS. Registered Apostle (i.e., on-going medical provider or case manager) charge alarm on patient’s behalf. First-time apostle can annals at the aforementioned time of alarm for a patient. Appliance and all affidavit for assets and allowance charge be faxed in afterwards alarm and approval. Upon approval, accommodating can aces up medication that day from any retail pharmacy, with $10 co-pay.

Special acknowledgment to NASTAD’s Britten Pund and Amanda Bowes. Adapted from Biologic Aggregation Accommodating Abetment Programs and Cost-Sharing Abetment Programs for PrEP and PEP: bit.ly/1eFG2GU

[Note from TheBody: This commodity was originally appear by Positively Aware in April 2018. We accept cross-posted it with their permission.]

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