Download presentation
Presentation is loading. Please wait.
Published byKristopher Sullivan Modified over 9 years ago
1
ADAP ADVOCACY ASSOCIATION 2013 HIV/HCV CO-INFECTION SUMMIT Lynda Dee Fair Pricing Coalition PAPS & CO-PAY PROGRAMS
2
FAIR PRICING COALITION Martin Delaney Linda Grinberg 1999
3
FAIR PRICING COALITION FPC History Programs and Initiatives Common Form, HarborPath, Welvista HIV & HCV PAP Criteria HIV & HCV Co-Pay Criteria FPC Members & Contact Information
4
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
5
FPC PROGRAMS & INITIATIVES Initial pricing after FDA approval Medical CPI for price increases Patient Assistance Programs (PAPs) Co-Pay Programs for private insurance Co-Pay Programs for Part D clients PAP coverage for the underinsured
6
HRSA COMMON FORM Patient name & contact information Healthcare coverage Physician’s name & contact information Alternate shipping information Prescription information Signature of patient and provider http://www.nastad.org/Docs/110312_CPAPA.pdf
7
WELVISTA & HARBORPATH One stop shopping Transitioning from Welvista: Waiting list Licensed in only 21 states To HarborPath: All clients Licensed in all 50 states – one portal HarborPath.org - 855-300-8916
8
ABBVIE (ABBOTT) PATIENT ASSISTANCE PROGRAM (PAP) 500% of Federal Poverty Level (FPL) $4,788 per month/$57,450 per year Underinsured: Deductibles, Part D copays Participates with Welvista & HP
9
BOEHRINGER INGELHEIM (BI)PATIENT ASSISTANCE PROGRAM (PAP) 500% of FPL $4,788 per month/ $57,450 per year Underinsured: Deductibles, Part D copays Participates with Welvista, not HP
10
BRISTOL-MYERS SQUIBB (BMS) PATIENT ASSISTANCE PROGRAM (PAP) 500% of FPL $4,788 per month/$57,450 per year Underinsured: Deductibles, Part D co-pays Participates with Welvista In negotiaions with HarborPath
11
GENENTECH/ROCHE PATIENT ASSISTANCE PROGRAM (PAP) 950% of FPL $9,090 per month/$109,155 per year Contributes to Co-Pay Foundations Does not participate with Welvista/HP
12
GILEAD PATIENT ASSISTANCE PROGRAM (PAP) 500% of FPL $4,788 per month/$57,450 per year Underinsured: Deductibles, Part D copays Participates with Welvista and HP
13
JANSSEN PATIENT ASSISTANCE PROGRAM (PAP) 200% FPL $1,915 per month/$22,980 per year Makes FPL income exceptions Underinsured: Part D co-pays only Participates with Welvista and HP
14
MERCK HIV & HCV PATIENT ASSISTANCE PROGRAM (PAP) 500% of FPL $4,788 per month/$57,450 per year Underinsured: Deductibles, Part D co-pays Participates with Welvista & HP
15
VERTEX HCV PATIENT ASSISTANCE PROGRAM (PAP) Monthly household income $8,333 Annual household income $100,000 Underinsured: Case by case Currently discussing Part D & HP
16
ViiV PATIENT ASSISTANCE PROGRAM (PAP) ViiV (Formerly GSK & Pfizer): 500% of FPL $4,788 per month/$57,450 per year Underinsured: Part D co-pays only Participates with Welvista & HP
17
ABBVIE CO-PAY PROGRAM Covers first $50 of Norvir Covers first $200 of Kaletra Online & healthcare providers
18
BI CO-PAY PROGRAM Coverage after the first $25 paid Covers Viramune XR, not IR Does not cover Aptivus Providers, ASOs and pharmacies
19
BMS CO-PAY PROGRAM Covers first $200 Reyataz/Sustiva Covers first $400 for Atripla/Gilead Online or healthcare providers
20
GENENTECH HIV AND HCV CO-PAY PROGRAM No official co-pay program Donations to Non-Profit Foundations Depending on Availability of Funds Private Insurance Patients Medicare Part D Patients
21
GILEAD CO-PAY PROGRAM Covers first $400 for Atripla, Complera and Emtriva Covers first $200 for Emtriva, Truvada and Viread Providers, ASOs, pharmacies
22
JANSSEN CO-PAY PROGRAM Coverage after first $5 paid Prezista, Intelence, Edurant Coverage unlimited thereafter Online or healthcare provider
23
MERCK HIV & HCV CO-PAY PROGRAM Covers first $400 for Isentress Covers first $200 for PegIntron 20% of 12 Rxs/44 weeks of Victrelis Online or healthcare provider
24
VERTEX CO-PAY PROGRAM HCV only $10,000 for Incivek No income limit Vertex or pharmacies
25
ViiV CO-PAY PROGRAM ViiV (Formerly GSK & Pfizer): Covers first $200 Online or healthcare provider Must re-enroll for 2013
26
FAIR PRICING COALITION fairpricingcoalition.org Bill Arnold Paul AronsBruce Burkett Jeff Berry Ryan ClaryLanny CrossLynda DeeDavid Evans Murray PennerMichael Ninburg Murray Penner Lorren Sandt
Similar presentations
© 2025 SlidePlayer.com. Inc.
All rights reserved.