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I can't afford my meds.anymore
May 5, 2008

The company I work for has a $6500.00 cap on meds. through BCBS. Needless to say $6500.00 doesn't last very long when you are on Atripla. Currently Atripla is $1488.00 per month. This will cover about 4.5 months of coverage. I am currently taking an additional 5 medicines. ADAP does not include these additional meds in their formulary. After 4.5 months I must pay the other 5 meds out of pocket. My solution is to take the Atripla every 5th day so it will last me several more months. This way my insurance benefits will last longer and I can also be covered for my other meds and won't have to go without food or shelter. How does this sound to you?

Response from Dr. McGowan

Unfortunately, your story is becoming more and more common lately. I would not recommend taking your Atripla intermittently. While the combination is a highly potent one it remains vulnerable to drug resistance because the virus only needs a couple of mutations to break through. These mutations are much more likely to develop on intermittent treatment. Since you have ADAP, I would use it to cover your Atripla, the "cap" should not apply. Discuss your other medications with your medical provider to see if cheaper/generic alternatives are available. Speak to your company about the availability of alternative options for insurance which may have no prescription cap. Also, in New York State where I practice, ADAP will help people pay for insurance premiums through its'ADAP Plus Insurance Continuation (APIC) program. It may be possible to use APIC, to buy insurance that would cover your medications. Pharmaceutical companies also have programs to provide assistance with access to treatment for people without resources, however the income limitations on these plans make them unlikely to be available for someone working full time.

I hope you are able to continue your treatment without interruption.

Best, Joe


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