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Prescription Assistance STAT!!
Jan 16, 2011

Hi Mr. Fawcett - I was diagnosed HIV+ in June 2010. My numbers have come in as follows:

6/14/10 - CD4: 371; VL: 6390 8/17/10 - CD4: 335; VL: 3710 10/19/10 - CD4: 352; VL: 8470 1/4/10 - CD4: 328; VL: 11320

I just left my doctor visit with the high recommendation that I begin medication. My issue is paying for the medicine. He gave me options some time ago and I did a lot of research on the side effects and the expense. I will start Atripla soon basically because of the once-a-day dose and more realistically, I cannot afford to take the combination therapy of three different drugs (except, of course, Atripla, which is three drugs in one pill).

I have a job with really shitty insurance. I have to pay 50% of all non-generic prescriptions; a plan called "cost sharing." Yay! I have savings, but when I blow through that and I'm HIV+ AND BROKE... what then?

I do not qualify for ADAP. I do not qualify for the Atripla Patient Assistance Program because I have insurance, albeit not ideal, and make too much money. I have priced Atripla at nine different retail pharmacies and my cost per month would be anywhere from $920 - $1,148. Atripla is not covered under Oxford's Mail Order Pharmacy (I have appealed that decision).

I have insurance but my prescription plan is awful. Where else can I find assistance until I find a different job in this horrible economy?

Thank you so much!

Response from Dr. Fawcett

I commend you on your research and empathize with the struggle to pay for medication. Unfortunately patient assistance programs are being pummeled by governmental funding crises. Every state and locale has different programs, the status of which are constantly changing. Some places have funds to help for medication co-payments, although these are few and far between. I would check with your local AIDS service organizations which often have staff who do nothing but deal with insurance and funding issues such as yours. They would have the most current information. Also be sure to copy your state's insurance commissioner on your appeal for coverage of Atripla. I know your efforts are not without emotional stress. Try to convert anxiety into action - anything you can do to increase your feeling of empowerment (even writing letters and making calls) will be beneficial.



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