AIDS prevention may be revolutionized if healthcare providers start to write more prescriptions for Truvada as a preventative measure for people at high risk for contracting HIV. As reported in the The New York Times, the U.S. Centers for Disease Control and Prevention is pushing for expanded use of Truvada as a prophylactic to prevent new HIV cases. To date, it has been primarily used to treat people who have already contracted HIV. If this recommendation is adopted, the number of prescriptions written for Truvada could increase from less than 10,000 per year to 500,000 per year, hopefully lowering the rate of new HIV infections, which has remained steady at 50,000 per year over the past decade.
But what if patients can’t access Truvada because of its cost? After all, a drug doesn’t work if a patient can’t afford to take it. The drug has a monthly cash price of about $1,500 at local U.S. pharmacies. Fortunately, Truvada is usually covered by insurance and Gilead offers an assistance program that covers the first $200 of a co-pay. They also have a program that covers the full cost of the drug for eligible uninsured or underinsured patients. Eligibility is not guaranteed to all!
Even if you’re insured and prescribed Truvada, the high cost might mean difficulties when it comes time to fill the prescription. Many pharmacy benefit formularies put the drug in tier 2 or 3, which means high co-pays. Other formularies place Truvada on a list of drugs that require pre-certification. In that case, the drug might not even be covered at all!
According to FiercePharma, dramatic increases in the number of prescriptions written for Truvada (and therefore requests for pharmacy benefit reimbursements) could increase co-pays and also curtail assistance programs. If that happens, patients may find themselves having to fork over a lot of cash for higher copays, deductibles or co-insurance. Some may very well end up stuck with a $1,500 per month bill.
For these patients, or anyone else who falls through the cracks, international online pharmacies may be an option. Truvada – the brand – is available for about $543.00 internationally; the generic – emtricitabine/tenofovir – not yet available in U.S. pharmacies, is $224.00. This could provide a lifeline for Americans who are prescribed Truvada in the coming years.
Last summer we reported on the prohibitive costs of AIDS and H.I.V. drugs in America. Due to high drug prices, plus overcrowded and inefficient AIDS Drug Assistance Programs, individuals suffering from these diseases live in fear, not knowing if they will get the meds they need. Sadly, the problem has gotten worse.
A recent discussion on an AIDS/H.I.V. community web forum is what caught our attention. In that forum’s thread entitled “Links to Stop White House from Blocking Online Pharmacies”, outspoken members have voiced outrage over recent price hikes of critical HIV medications.
As reported by the AIDS and H.I.V. advocacy website and monthly magazine POZ.com, Gilead Sciences, a major manufacturer of AIDS and H.I.V. prescription drugs, has increased prices for its top HIV medications. “Atripla increased by 5.1 percent, and Truvada and Emtriva increased by 7.9 percent.” Comparing prices for these drugs at a local New York bricks and mortar pharmacy to licensed and verified foreign pharmacies, one finds substantial price discrepancies:
We recently wrote on prescription assistance programs, though the focus was primarily on uninsured and underinsured seniors. This week we shift that focus to the H.I.V. and AIDS populations.
According to the National Alliance of State and Territorial AIDS Directors, the H.I.V. and AIDS populations are suffering more than ever when it comes to carrying the burden of prescription costs, due to our failing economy and poorly financed healthcare. H.I.V. and AIDS patients – who, on average, have annual drug bills of $12,000, are being dropped from their prescription assistance programs, told that their state’s programs are capped or closed, or placed on a seemingly endless waitlist for assistance. What’s more, as enrollment for drug assistance has increased (12% from 2008 to 2009 according to the New York Times), government funding has stayed more or less the same. (more…)
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