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Sharing Medications With a Friend
Mar 18, 2009

A friend of mine takes kaletra as part of his regimen, and is currently having financial difficulty that is affecting his ability to afford his meds. My friend falls through the cracks because he technically has insurance through his job and he pays a ridiculous amount for his meds because of poor coverage. But because of his barely above minimum wage salary, he doesn't qualify for ADAP. He has cut back to taking 1 kaletra pill a day instead of 4. I used to take kaletra and had an old prescription that I was going to refill and give to him since my insurance covers all but a $20 copay. However when I went to refill it online, I noticed that my prescription expired on 02/19/09. I requested a refill anyway and the pharmacy contacted my doctor to approve it. I was hoping he would just sign off on it, but his nurse called me to ask why I was refilling the kaletra. I was honest with her and told her that it was to help out a friend and she said the doctor refused to refill the med, even for a 30 day supply. Was my request to my doctor unethical or unreasonable? My thinking was that in these tough times, people with HIV shoud pull together to get what we need to take care of ourselves even if it means 'working the system'. What are other people doing in this situation?

Response from Dr. Frascino

Hi,

Your friend's predicament is all too common. Not only do we have 47 million folks without any health insurance in this country, but we have an additional 25 million who are underinsured, like your buddy. Finally we have a president in office that is serious about resolving this morally reprehensible problem.

Unfortunately your doctor cannot legally or ethically fill prescriptions under your name to be used by patients he is not caring for. Should your buddy have a problem with his medication, your doctor would be held responsible. Physicians cannot prescribe medications to folks who are not under their care. This makes sense from a safety perspective.

Please advise your buddy taking one Kaletra pill a day instead of four is a very bad idea. Suboptimal dosing will lead to HIV-drug resistance rendering Kaletra and perhaps other drugs in that class no longer effective. I strongly urge him to see his HIV specialist without delay. He may well need an HIV-resistance test to see if he's developed resistance that would necessitate a change in his regimen. He should discuss his financial concerns with his HIV doctor. There may well be AIDS service organizations in your area that might be able to help. Some pharmaceutical companies have compassionate-use programs. Barring that, enrolling in a clinical trial may be an option.

Was your request to your doctor unreasonable? No, you intentions were to help your friend, not scam the system. However, it would have been unethical and unreasonable for your HIV specialist to prescribe potent medication for someone who is not under his care.

Good luck to both you and your buddy.

Dr. Bob



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