Cutting MEDS

[HealthyGuy]

I have been on SUSTIVA and Combivir for well over 12 years and they work great for me. I did the full Clinical trails until they ended and used my insurance to continue treatment. I have been undetectable since the third month except once in the beginning when I broke a rib. So here I am going along and now my insurance just changed to a HSA plan. I got my meds yesterday and my bill was well over $3000 for 90 days! Anyone out there ever tried splitting their meds without affecting their numbers? I cannot afford to payout of pocket then wait for reimbursement that will now only be 50% of that. My yearly total will be over $6000 for the meds after I meet my $1500 deductible. I don’t want to mess with my health but I also cannot afford my new insurance plan. I was paying $160 for a 90 day supply. My employer SUCKS!

[mecch]

There was some member here i seem to recall who posts on taking his HAART every other day.  Anyone can help find that?
There is also new new research about the possibility of treatment protocals being changed for long-term undetectable people.  Anyone have that link?
But its all unsupported right now by official medical advice.
What a rotten situation! Please go to local social services and or AIDS services and explain the situation to see if there are other options.
Please also check with your doctor.

[sharkdiver]

Have you talked with your HR person about your plan?  I have an HSA and once i pay the 1500 (which is the first time I refill my meds) then everything else is covered. Are you saying you have to pay a % after you meet your deductible? Are you contributing to your HSA every month? There was a lot of confusion at work when we switched over as well.

as far as splitting your meds, sounds like a plan to build resistance if you don't have enough of the meds in your bloodstream.

Good Luck and get this sorted out

[HealthyGuy]

They SPRUNG the HSA on us! Had a meeting  (I was on conference) and gave us 5 days notice. We were told to order any meds we needed before the 1st. I was on the road and did not have my information with me to do that, so I ordered when I got home after the 1st and WHAM!  HR not where I work very small company. I was reading through everything yesterday and it is a 80/50 plan. I pay the first $1500 and they cover 80% medical after that and 50% RX. Insult to injury after 6 years and no raise ever and only 5 days vacation a year. I knew it was time to move on but this was more than the frosting on the cake.

[Inchlingblue]

As far as cutting meds it's not ideal nor recommended but there are some drugs that are more "forgiving," as far as their half-life in your body. Check out info below on the FOTO study, which evaluates a treatment strategy involving five days on, two days off a Sustiva-based regimen.

There are programs that can help with covering insurance costs, such as ADAP and also co-pay assistance programs with the pharmaceuticals, see link below.

Another strategy is to see how soon you are able to re-fill your Rx. In my case, I can refill every 22 days so I make sure to do that and essentially have an extra week of meds every month so I'm building up a reserve supply.

LINK  TO CO-PAY ASSISTANCE PROGRAMS:

http://positivelyaware.com/2009/news_briefs/news_briefs_09_02_03.shtml

LINK TO FOTO  STUDY (scroll down):

http://www.thebody.com/content/confs/ias2009/art53122.html

[HealthyGuy]

Thanks Inchlingblue, the co-pay assist is very small amount but even that will help some. The other site for FOTO was great information! I didn’t think of that. During the Clinical trail of SUSTIVA I was asked to continue until the end because so many of the people were not good with sticking to doses. Many were street people and druggies looking for free meds and the payment for taking part. I was just a working guy looking for answers and willing to follow through.

What I found interesting about the FOTO is the two off, five on. I would think it would be better to stager the days off say three on one off. That way the drug remains in your system the entire time. Too bad they did not take this study out longer.

[Inchlingblue]

Since FOTO was done with Sustiva/Truvada, I would not recommend doing it with Combivir. Did you notice what  Dr. Gallant said in the interview:

Think back to the old days of Combivir and Crixivan [indinavir, IDV], when perfect adherence was really what it took to succeed.

Have you thought of replacing Combivir with something newer and less toxic?

You can ask Dr. Gallant his opinion on his website, he's very good:

http://www.hopkins-hivguide.org/q_a/index.html?categoryId=9352&siteId=7151

You should also look into ADAP and other programs that help those with HIV who have insurance pay for their premiums or co-pays.

[HealthyGuy]

I would not think of doing anything without talking to my specialist first. I have an appointment for next Friday and I will be discussing a lot more than usual since this HSA just slapped me in the face a few days ago. Like I said a 30 day notice would have been nice, but I work for greedy brothers that lack of communication is their first name. I actually thought about using the HSA money to pay into my partners health plan since the money is pretax and his is a better plan now than mine. $160 more a month but only $20 co-pay for RX including my meds. Far cheaper now than mine, just need to find out if I can go on it now or have to wait a bit. He thinks it is open in October for January start. I currently pay $380 a month for my own health plan through work, another thing they don’t pay for.

[mecch]

I was thinking about your situation, cause its really scarey and unjust and frustrating and just a total bummer.
I hope you fight to find a solution, cause after all these good years of adherence you need a break and deserve continued health.
But, I dont even dare say it, but if worse comes to worst, rather than cutting done because you cant afford full HAART treatment, I think you would ask you doctor how to do a total stop until you get a solution worked out. That way, if done correctly, you wouldnt have resistance issues, which are possible on a less than ideal HAART regime. Correct?  But hopefully it wont come to that.

[Miss Philicia]

You should also look into ADAP and other programs that help those with HIV who have insurance pay for their premiums or co-pays.

Exactly.  HealthyGuy, do you have a case manager and/or a local ASO (AIDS Service Organization) that you can go to for an assessment?

[HealthyGuy]

Other than my specialist I don’t have a case worker. I have never felt the need to even ask for help until this happened. I live in a rural area not to far from a city where I am sure I could find help. But problem two is I am on the roar 98% of the time and never near my home base. So this makes it hard. As I posted I was on the road when they slammed us and told us we should order any meds ASAP. I did not return home before the cut of date to get my last refill under the old plan.

I do thank all of you here for your support and thoughts on what to do and try. This has been unbelievably great. I have always refused to allow HIV to run my life and I am NOT going to start now. 

[HealthyGuy]

Yes I roar but I did mean road! LOL