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follow up about Selzentry and Isentress

Aug 16, 2012

Dear Dr McGowan, Hi! This is Felicia again. Thanks for answering. I wanted to clarify that I have never been on treatment until 2 years ago = the only drugs I have taken are Kaletra and Truvada for 2 years now. Also, I have taken the tropism test and I am able to take Selzentry (Maraviroc). I have 2 questions as follow up:

1.. I am on medicare and medicare only covers 70% of the drug costs. I do not qualify for ADAP so I need to pay $550 for Isentress or $512 for Maraviroc a month. I will only be able to pay for one a month. Which one is better especially for someone who hopes to get in a Hep C trial?

2. Has Selzentry and Isentress and Truvada (which is made up of 2 drugs as you know) been studied together? I know you stated in your previous email that all should be on 3 drugs. Yet, with doing both = a four drug combo. Huge thanks.


Response from Dr. McGowan

Felicia, one thing you should look into is the Co-pay coverage cards that are avaialable from the manufacturers for most of the ARVs. Some cover up to $400 per month in co-pays. This may help you stay on your regimen. Ask your pharmacist or social worker (if available) about this option...even people who are not eligible for ADAP can use these cards. Isentress has no interactions with the Hepatitis C protease inhibitors. The Hep C PIs may effect maraviroc levels, no dosing guidance has been provided. The decision about which to use should be based on the drug resistance profile of the virus (sorry I don't recall what your virus resistance profile was). The 4 drug combo has not been studied specifically...although no drug interactions are would need to be monitored closely. Joe

very low cd4 count
Decitabine & Gemcitabine

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