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alternative to truvada?
Feb 14, 2013

I have been HIV+ for more than 20 years. I have been undetectable for a few years and having t-cells over 1000. However, because of the extreme expenses in doctor, labs and prescription co-pays, I can no longer afford to pay for my meds. I am blessed to have my insurance premium paid by AICP, but these extra expenses make it impossible to survive with wages of only $11.00 per hour.

I contacted the pharmaceuticals, and thanks to their co-pay assistance programs, I am able to get a huge discount. However, since Truvada is the most expensive medication I take, I still have to pay almost $600. Do you know any alternatives?

Response from Dr. Young

Hi and thanks for posting.

Paying for medications can frequently be a challenge. I'm a bit confused as to the source of your $600 costs, if you're already getting copayment assistance from Gilead, as their program usually covers all the costs. Is it rather that the cost comes from your insurance company's deductible? Make sure that you work with your case manager (if you have one) to sort out all of the options and possibilities.

Understanding the basis of your costs would help outline the best solution to the problem.

Assuming that their is a part of the overall cost of the medication (ie., Truvada) that is the basis of the cost, then a natural question is whether their is a lower cost alternative to Truvada.

To answer this, one should be careful to understand any history of drug resistance, or prior toxicity. Typically, when we're interested in switching patients off of Truvada, we look to abacavir/3TC (coformulated as Epzicom or Kivexa). The retail price of the combo pill Epzicom is typically expensive than Truvada; and so long as you're willing to take 2 pills instead of 1, generic abacavir and generic 3TC are available (in the US). Genetic testing should be done prior to using any abacavir product, to decrease risk of allergic reaction.

Hope that helps, BY

Response from Mr. Chambers

Dr. Young has offered alternatives to truvada should you need to discuss it with your doctor.

First, do you have health insurance? You don't mention it, so I assume you do not. Remember that beginning January 1, 2014, you will be able to purchase health insurance and, with your income, get significant financial assistance with paying for it.

Are you familiar with the AIDS Drug Assistance Program (ADAP)? It is federally funded and operated by each state. With your income, you should qualify for the program. Once enrolled, it will pay 100% of your drug bills for prescriptions that aren't paid by someone else as long as the medication is on the ADAP formulary.

Contact a local AIDS Service Organization in your area for more information and help with enrollment. You may also want to do a browser search for "ADAP (and name of your state)"

I should mention that the ease of joining the program and the medications covered vary dramatically by state.

Good luck, Jacques



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