Transcript Slide 1

ADAP ADVOCACY
ASSOCIATION
2013 HIV/HCV
CO-INFECTION SUMMIT
Lynda Dee
Fair Pricing Coalition
PAPS & CO-PAY PROGRAMS
FAIR PRICING COALITION
Martin Delaney
Linda Grinberg
1999
FAIR PRICING COALITION
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FPC History
Programs and Initiatives
Common Form, HarborPath, Welvista
HIV & HCV PAP Criteria
HIV & HCV Co-Pay Criteria
FPC Members & Contact Information
FAIR PRICING COALITION
 Worked with ADAP Directors
 First ever price freeze (2 years in 2002)
 Resulted in $50MIL to ADAPs
 Works with ADAP Crisis Task Force
 Involved in HCV since 2010
FPC PROGRAMS
& INITIATIVES
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Initial pricing after FDA approval
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Medical CPI for price increases
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Patient Assistance Programs (PAPs)
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Co-Pay Programs for private insurance
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Co-Pay Programs for Part D clients
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PAP coverage for the underinsured
HRSA COMMON FORM
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Patient name & contact information
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Healthcare coverage
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Physician’s name & contact information
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Alternate shipping information
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Prescription information
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Signature of patient and provider
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http://www.nastad.org/Docs/110312_CPAPA.pdf
WELVISTA
& HARBORPATH
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One stop shopping
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Transitioning from Welvista: Waiting list
Licensed in only 21 states
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To HarborPath: All clients
Licensed in all 50 states – one portal
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HarborPath.org - 855-300-8916
ABBVIE (ABBOTT) PATIENT
ASSISTANCE PROGRAM (PAP)
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500% of Federal Poverty Level (FPL)
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$4,788 per month/$57,450 per year
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Underinsured: Deductibles, Part D copays
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Participates with Welvista & HP
BOEHRINGER INGELHEIM
(BI)PATIENT ASSISTANCE
PROGRAM (PAP)
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500% of FPL
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$4,788 per month/ $57,450 per year
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Underinsured: Deductibles, Part D copays
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Participates with Welvista, not HP
BRISTOL-MYERS SQUIBB (BMS)
PATIENT ASSISTANCE
PROGRAM (PAP)
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500% of FPL
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$4,788 per month/$57,450 per year
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Underinsured: Deductibles, Part D co-pays
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Participates with Welvista
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In negotiaions with HarborPath
GENENTECH/ROCHE PATIENT
ASSISTANCE PROGRAM (PAP)
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950% of FPL
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$9,090 per month/$109,155 per year
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Contributes to Co-Pay Foundations
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Does not participate with Welvista/HP
GILEAD PATIENT ASSISTANCE
PROGRAM (PAP)
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500% of FPL
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$4,788 per month/$57,450 per year
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Underinsured: Deductibles, Part D copays
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Participates with Welvista and HP
JANSSEN PATIENT ASSISTANCE
PROGRAM (PAP)
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200% FPL
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$1,915 per month/$22,980 per year
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Makes FPL income exceptions
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Underinsured: Part D co-pays only
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Participates with Welvista and HP
MERCK HIV & HCV PATIENT
ASSISTANCE PROGRAM (PAP)
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500% of FPL
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$4,788 per month/$57,450 per year
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Underinsured: Deductibles, Part D co-pays
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Participates with Welvista & HP
VERTEX HCV PATIENT
ASSISTANCE PROGRAM (PAP)
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Monthly household income $8,333
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Annual household income $100,000
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Underinsured: Case by case
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Currently discussing Part D & HP
ViiV PATIENT ASSISTANCE
PROGRAM (PAP)
ViiV (Formerly GSK & Pfizer):
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500% of FPL
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$4,788 per month/$57,450 per year
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Underinsured: Part D co-pays only
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Participates with Welvista & HP
ABBVIE CO-PAY PROGRAM
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Covers first $50 of Norvir
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Covers first $200 of Kaletra
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Online & healthcare providers
BI CO-PAY PROGRAM
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Coverage after the first $25 paid
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Covers Viramune XR, not IR
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Does not cover Aptivus
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Providers, ASOs and pharmacies
BMS CO-PAY PROGRAM
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Covers first $200 Reyataz/Sustiva
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Covers first $400 for Atripla/Gilead
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Online or healthcare providers
GENENTECH HIV AND HCV
CO-PAY PROGRAM
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No official co-pay program
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Donations to Non-Profit Foundations
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Depending on Availability of Funds
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Private Insurance Patients
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Medicare Part D Patients
GILEAD CO-PAY PROGRAM
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Covers first $400 for Atripla,
Complera and Emtriva
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Covers first $200 for Emtriva,
Truvada and Viread
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Providers, ASOs, pharmacies
JANSSEN CO-PAY PROGRAM
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Coverage after first $5 paid
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Prezista, Intelence, Edurant
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Coverage unlimited thereafter
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Online or healthcare provider
MERCK HIV & HCV CO-PAY
PROGRAM
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Covers first $400 for Isentress
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Covers first $200 for PegIntron
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20% of 12 Rxs/44 weeks of Victrelis
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Online or healthcare provider
VERTEX CO-PAY PROGRAM
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HCV only
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$10,000 for Incivek
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No income limit
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Vertex or pharmacies
ViiV CO-PAY PROGRAM
ViiV (Formerly GSK & Pfizer):
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Covers first $200
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Online or healthcare provider
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Must re-enroll for 2013
FAIR PRICING COALITION
fairpricingcoalition.org
Bill Arnold
Paul Arons
Jeff Berry
Lanny Cross
Lynda Dee
David Evans
Murray Penner
Bill Arnold
Bruce Burkett
Ryan Clary
Lanny Cross
Lynda Dee
David Evans
Michael Ninburg
Murray Penner
Lorren Sandt