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Main Forums => Living With HIV => Topic started by: Stanley5739 on August 08, 2010, 09:20:35 pm

Title: $1,600 for Atripla ?!?!?!
Post by: Stanley5739 on August 08, 2010, 09:20:35 pm
 :o

As previously noted, I am new here, approaching the anniversary of my seroconversion.  (how to note such an event?  perhaps work on my house's electric wires while standing in a tub of water?  kidding, a bit)

Anyway, I pay $50 for my monthly dosage of Atripla under my company's insurance plan.  I asked the pharmacist how much it cost without any sort of plan or subsidy.  She went to the computer, checked, walked toward me, turned around, went back to the computer and checked again.  She then told me it was $1,600 for 30 pills.  Really.

Is this consistent with everyone else's understanding?  If so, I am ashamed of myself for not being sensitive to others without insurance, let alone those outside the USA.  Are there charities in the NY or NJ (home state) that help subsidize people who don't have insurance and need help paying for their meds?  That info may have already been posted elsewhere and I apologize if I missed that.

I guess my next line of questions will be how this works out under Medicare and Medicaid.  I have only a couple of years to 55 and realize I have to get myself together on this.  Any guidance will be of course welcome and patience with newbies such as myself much appreciated.

Good luck to everyone and stay strong.

Title: Re: $1,600 for Atripla ?!?!?!
Post by: phildinftlaudy on August 08, 2010, 09:31:05 pm
I pay a $20 co-pay for 30-day supply and the pharmacy says my insurance saves me $1,831.  There are some patient assistance plans and each state has ADAP (AIDS Drug Assistance Program) which pays for HIV meds for those who quality based on income requirements established by the state.  Many of these programs now have waitlists.
Title: Re: $1,600 for Atripla ?!?!?!
Post by: Rev. Moon on August 08, 2010, 09:59:52 pm
Yup, you and your pharmacist got that right. According to the receipt from my pharmacy my insurance plan saves me over $1,800 each month.  And that's the way the cookie crumbles.
Title: Re: $1,600 for Atripla ?!?!?!
Post by: mecch on August 08, 2010, 10:09:21 pm
  If so, I am ashamed of myself for not being sensitive to others without insurance, let alone those outside the USA.  Are there charities in the NY or NJ (home state) that help subsidize people who don't have insurance and need help paying for their meds? 

How has this lack of sensitivity manifested? 
The high cost of HIV/AIDS treatment never entered your orbit of awareness in all these years of the epidemic? 
Just curious to hear what you mean.

Also, since you seem naive on the topic, you know that the price of a combo varies considerably from country and to country... And some countries break patents and get the drugs to those in need.

And you also know that the USA is hardly the best place to seroconvert, if you factor in the lack of universal health care - and that many countries do have universal health care and the cost of HIV medicine doesn't have the overwhelming stressful presence it seems to have, or have had to date, for those with HIV in the USA.

You know all this, right?
Title: Re: $1,600 for Atripla ?!?!?!
Post by: Miss Philicia on August 08, 2010, 10:21:07 pm
I was once on a med regimen that came to $5000 each month.  Through a combination of Medicare Part "D" and ADAP my monthly cost came to $0.00
Title: Re: $1,600 for Atripla ?!?!?!
Post by: wtfimpoz on August 08, 2010, 10:51:15 pm
How has this lack of sensitivity manifested? 
The high cost of HIV/AIDS treatment never entered your orbit of awareness in all these years of the epidemic? 
Just curious to hear what you mean.

Also, since you seem naive on the topic, you know that the price of a combo varies considerably from country and to country... And some countries break patents and get the drugs to those in need.

And you also know that the USA is hardly the best place to seroconvert, if you factor in the lack of universal health care - and that many countries do have universal health care and the cost of HIV medicine doesn't have the overwhelming stressful presence it seems to have, or have had to date, for those with HIV in the USA.

You know all this, right?

I'm sure he's aware that if he lived in any other developed nation, it wouldn't be so hard for others, or for him if the shit hits the fan.  He's probably alsso aware that its too late to get out of here.  What I want ot know is why you're rubbing it in?
Title: Re: $1,600 for Atripla ?!?!?!
Post by: phildinftlaudy on August 08, 2010, 11:00:20 pm
I'm sure he's aware that if he lived in any other developed nation, it wouldn't be so hard for others, or for him if the shit hits the fan.  He's probably alsso aware that its too late to get out of here.  What I want ot know is why you're rubbing it in?
I agree Wtfimpoz - I also thought the response of Mecch didn't responded to the OP and really wasn't justified especiallly coming from a member with 3,429 posts in response to a member with 6 posts - particularly when that member iwith six posts dentifies themself as being new here and just celebrating one year positive (and a member since November - so about 9 months)

I know that - God forbid - I was diagnosed with diabetes - I would not have a clue as to what goes on in the US in regards to medicine costs related to diabetes medications, etc. or for that matter any other number of diseases out there that I might come down with some day.  However, after being diagnosed I would find out as much as I could about the disease - which is what I think the OP was doing here - only to be met with a harsh response, non-empathetic, and arrogant.  Hopefully, other members will be more helpful or at least will be able to concur with what the OP has shared.
Title: Re: $1,600 for Atripla ?!?!?!
Post by: Stanley5739 on August 08, 2010, 11:25:24 pm
Many thanks to all who replied, including mecch.  He has a point and I am grateful for all views.  I am educating myself, albeit a bit slower than many.  As I come to terms with the illness, I continue to find ways that I need to be a better citizen of this community. 

Sure, I contribute regularly (and did pre-seroconversion) to organizations like AmFar, GMHC and to God's Love We Deliver, but I have to admit that hearing that number for the first time really brought home the plight of others in paying for their meds.  Knowing something is "expensive" is one thing, knowing the actual dollars it takes is another, at least in my case.  So, I realize I need to understand more and now to do more, which is why I asked what programs focus on that aspect of our disease.

It would be great to live in a country with the most enlightened health care.  It would be great not to have to worry about what I face down the road once I no longer work somewhere with a health plan.   But for now, as I start to come to terms that HIV is part of my life and probably always will be, I need to keep perspective on how it affects others.  And in any humble ways how I can help.  So tomorrow I research more about the ADAP and see where to write that check.  I am not wealthy but hell, anything to chip at $1,600 to $1,800 -- or $5,000 -- is at least a start.

Again, this forum is invaluable in my education.  Thanks.
Title: Re: $1,600 for Atripla ?!?!?!
Post by: Miss Philicia on August 08, 2010, 11:33:58 pm
Stanley, you don't make donations to ADAP -- it's a joint federal/state government program.

Otherwise Stanley, once you retire and have Medicare it has a prescription program like any other insurance policy to pay for medication, though there are slight costs like co-pays.  If you're really poor once you are on Medicare then ADAP would "wrap around" and pick up even those co-pay costs, generally.  Obviously you have enough time to learn what's what with this issue before it will be an issue for you.

And to the others commenting in this thread I can see where meech is coming from -- Stanley is a 53 year old gay male in the NYC metropolitan area.  Assuming he's lived there since the beginning of the AIDS epidemic you'd assume he would have had enough friends that have dealt with the issue that he'd have at least some slight idea that HIV medications were very expensive.
Title: Re: $1,600 for Atripla ?!?!?!
Post by: jkinatl2 on August 08, 2010, 11:40:58 pm
Oh, but wait! If a person takes a combination like mine, which is Norvir boosting Prezista, Isentress and Truvada, that price goes up considerably. The pharmacy I attend is kind enough, every month, to put the "retail price" on my medical bottles:

Norvir: US$700 per 30 day supply
Truvada: US $350 per 30 day supply
Isentress: US $950 per 30 day supply
Prezista: US $850 per 30 day supply.

Add to that any other meds one takes, for sleeping issues associated with the HIV meds or the intestinal issues, and the total can - and does - easily reach beyond US $3000 per month.

It's crazy.

Thanks to Medicare part D and my Ryan White coverage, my personal total varies from US $50 to US$5, depending ont he time of year. I could not imagine any product placed further from the reach of the retail consumer than HIV drugs. Though I am absolutely certain some exist :)



Title: Re: $1,600 for Atripla ?!?!?!
Post by: Stanley5739 on August 08, 2010, 11:50:53 pm
You are right.  If I was a gay male living in NYC since the 1980s, I probably would have known exactly how expensive the medication can be.  But I didn't mean this to be so much about me as the expense.  So I continue to show my ignorance now in learning that ADAP is wholly a government program.  I guess I have to find another way to help.  Again, the people on this forum know a great deal more than others.  Perhaps I should just keep my questions to myself after all.
Title: Re: $1,600 for Atripla ?!?!?!
Post by: Granny60 on August 08, 2010, 11:56:48 pm
Husband's Atripla is $1844.00 per month. $1600.00 is about what it was  in early 2008. All our meds together is around $5,700.00 per month.  Thank GOD for insurance.
Title: Re: $1,600 for Atripla ?!?!?!
Post by: jkinatl2 on August 09, 2010, 12:19:23 am
Husband's Atripla is $1844.00 per month. $1600.00 is about what it was  in early 2008. All our meds together is around $5,700.00 per month.  Thank GOD for insurance.

Honestly, for people who fall through the cracks, I fail to see how there is hope at all.
Title: Re: $1,600 for Atripla ?!?!?!
Post by: Hellraiser on August 09, 2010, 12:43:48 am
Honestly, for people who fall through the cracks, I fail to see how there is hope at all.

For once you and I are in total agreement.
Title: Re: $1,600 for Atripla ?!?!?!
Post by: jkinatl2 on August 09, 2010, 01:42:42 am
For once you and I are in total agreement.

This is why it is so important that those of us who are capable of doing something, DO something. I can expound on message boards all day. Some of us are actually working towards becoming elected officials where they live!

I do not ... AT ALL ... desire that sort of thing. But when I see a chance to write a letter, I do (not a petition online, those are regarded as, at best, a single letter). When there is a meeting, i try to be there. Because someday I might fall through those same cracks... and if I have not spoken for anyone, how can I expect anyone to speak for me?

In about six months, Viagra will be on the list for generics (they got the extension because low dose V helps children with heart problems). Seriously? There are HIV drugs without generics that have been on the market for FOR LONGER. Not that I do not care about children with heart problems... but our society is being consumed by these horrific drug costs, which have paid for R & D tenfold already.

Title: Re: $1,600 for Atripla ?!?!?!
Post by: littleprince on August 09, 2010, 04:24:20 am
I notice that pharmacies in Australia have started printing the 'full price' on drug labels now. I think it's there to remind us just how much the government subsidizes drugs. Kaletrea/Truvada for 1 month = $AU1520.94. Cost for all residents = $AU66.60.
Title: Re: $1,600 for Atripla ?!?!?!
Post by: mecch on August 09, 2010, 08:21:09 am
You are right.  If I was a gay male living in NYC since the 1980s, I probably would have known exactly how expensive the medication can be.  But I didn't mean this to be so much about me as the expense.  So I continue to show my ignorance now in learning that ADAP is wholly a government program.  I guess I have to find another way to help.  Again, the people on this forum know a great deal more than others.  Perhaps I should just keep my questions to myself after all.

Not at all!  Some members gave me a ribbing but I appreciate you saying that you understood my post.

I meant that I think it is important that a newbie, if he is ready, take on a lot of information and it seems that you are ready!  So you should ask all your questions!  

I gave that information about people in other countries because you seemed to worry more about others than yourself, and some of the others are doing very well indeed.  

(For example from my own experience, I saw some American friends and lovers suffer horribly in the 80's and than again in the 90's due to unaffordable health care they needed. So it raises my hackles if some American claims to have the best health care in the world and feels worried about those in "other countries" because it might to be ignorance speaking.  Not saying that is what you said, just saying that I offered that perspective to open your eyes.)

In the end, its your own situation that you have to address first and foremost.  Learn everything about how to secure your own funding for HAART for as long as it will be necessary - maybe for life, or until a cure.  

Some people think my response doesn't relate to your post but I disagree.  For example I was totally shocked by the cost of my HAART, because I grew up in America and I have in my bones an American fear of health care cost and long term changes to my life purely due to financial pressures.  My Swiss friends really helped put this in perspective because they couldn't understand my point of view whatsever.  Its like that story of the Dalai Lama not getting "depression" when he first visited the west, because its a feeling and a definition that doesn't exist in his culture.   My Swiss friends said over and over again - look, its not your money, its society, look your insurance is NEVER going to disappear as long as you live here, look you'll always have the health care you need.  Over and over again.

The pharmacist was really cool. When I first filled my HAART prescriptions, I was worried about "what ifs" - what if I lose some. What if I need to travel. What if what if.  She said "we are not counting pills here, if you need medicine come and get it".  

I was a little surprised when about 1.5 years into HAART I switched to Isentress and she did a double take about the price.  

Even she was shocked!

Your post is a little bit about all the feelings that surround the price of this medicine!  The price of treatment.

Good luck on this new path.  
Title: Re: $1,600 for Atripla ?!?!?!
Post by: Inchlingblue on August 09, 2010, 09:17:36 am

Otherwise Stanley, once you retire and have Medicare it has a prescription program like any other insurance policy to pay for medication, though there are slight costs like co-pays.  If you're really poor once you are on Medicare then ADAP would "wrap around" and pick up even those co-pay costs, generally.  Obviously you have enough time to learn what's what with this issue before it will be an issue for you.


Miss P, it's remarkable you've had such an easy time through the years accessing care and meds for free or very cheap. I'd say it's partly timing? It also seems to be a bit easier to qualify for aid when one is disabled and not making much money? The current system in the US is set up such that anyone with a chronic illness who is not either very well off or very poor has a hard time continuing a normal life and working a regular job that may not have the best coverage. It seems to be easier to afford meds and care if one gets sick and becomes unemployed. I know you had private insurance at one time but didn't you eventually qualify for disability, which means your income is limited? What if you worked a job that offered crappy or no insurance but your income was too high to qualify for ADAP?

And as good as ADAP is, it's not health insurance. It's just meds and labs. If anything else happens there's no coverage.

There are more than 2,300 people (and counting) currently on ADAP waiting lists and countless others who are underinsured and others who can't afford meds and make just enough not to qualify for ADAP (income restrictions for which are becoming more strict) or those with Medicare who can't keep up with the dreaded "doughnut hole."

David Capogna, who blogs on poz.com, has horror stories about the doughnut hole:

http://blogs.poz.com/dave/archives/2010/04/the_half-baked_donut.html

Stanley, feel free to ask what you like.  
Title: Re: $1,600 for Atripla ?!?!?!
Post by: tommy246 on August 09, 2010, 10:06:42 am
the atripla i get free here in spain from the hospital has the pvp price on the bottle of 30 pills its about 750 euros
Title: Re: $1,600 for Atripla ?!?!?!
Post by: Miss Philicia on August 09, 2010, 10:17:55 am
Miss P, it's remarkable you've had such an easy time through the years accessing care and meds for free or very cheap. I'd say it's partly timing? It also seems to be a bit easier to qualify for aid when one is disabled and not making much money? The current system in the US is set up such that anyone with a chronic illness who is not either very well off or very poor has a hard time continuing life as normal as possible and working a regular job that may not have the best coverage. It seems to be easier to afford meds and care if one gets sick and becomes unemployed. I know you had private insurance at one time but didn't you eventually qualify for disability, which means your income is limited?

There are more than 2,300 people (and counting) currently on ADAP waiting lists and countless others who are underinsured and others who can't afford meds and make just enough not to qualify for ADAP (income restrictions for which are becoming more strict) or those with Medicare who can't keep up with the dreaded "doughnut hole."

David Capogna, who blogs on poz.com, has horror stories about the doughnut hole:

http://blogs.poz.com/dave/archives/2010/04/the_half-baked_donut.html

Stanley, feel free to ask what you like.  

1) I've had a relatively easy time because I've not lived in a "red state" -- I've lived in two states (NY and PA) where there are high rates of HIV infections, and further within those states in the two cities with the highest rates of infection within those respective states.  The wheels couldn't be greasier for me.

2) I had a decent paying job when I lived in NYC, at least towards the last five years before I went on disability.  IIRC the SSDI income amount is based on some formula as regards one's last  three years of employment.  I always got statements from Social Security every other year stating clearly what amount I would get if I was ever disabled, so when I had to go in I knew what it would be.  However, because I was diagnosed in my late 20's and during the time frame pre-HAART, I simply never bothered accruing any assets because I didn't expect to live past the age of 35.  Never bought property, never owned a car (didn't need one in NYC and we all know the rent scene there) so when I stopped working yes, my situation was easy in terms of there not being any complications asset wise for getting my medications.

3) I really can't speak for David Capogna.  I don't know where he lives, and I don't know the details of his finances.  From what I've seen in the two states I live in (can't speak for other locations) you'd have to have something like dividend/asset income while on disability that puts you over the ADAP eligibility cut off to prevent there being a wrap-around to cover the donut hole.  Yes, I have a friend in such a situation, but he jets off to San Francisco several times a year, owns a condo, has a car so I can't feel but so sorry for him.  I think he has a pension as well.

Title: Re: $1,600 for Atripla ?!?!?!
Post by: Inchlingblue on August 09, 2010, 10:45:19 am
David Capogna lives in NYC.

I don't make all that much but my job has good insurance. If I lost my job I have assets just slightly above what would allow me to qualify for ADAP and, as mentioned before, ADAP is not health insurance anyway.

Maybe this new health care plan will make things better, who knows?

Thomas DeLorenzo blogged about not being able to go back to school for a law degree because it would mean having to drop his current expensive insurance in CA, which would leave him high and dry and not able to get coverage elsewhere:

http://www.thebody.com/content/art57953.html

When I hear Mecch talk about how it is to have HIV in Switzerland it seems so . . .  civilized. People can continue living good productive lives without the constant fear of losing health care coverage.

60 Minutes did a piece yesterday on current Medicare policies regarding end of life. It was absurd. A 93-year old with cancer and renal disease (among other things) can still get a heart defibrillator put in at huge expense even though he's going to die in a matter of weeks anyway. The waste and mismanagement of the US system will bankrupt us, it's simply not sustainable.
Title: Re: $1,600 for Atripla ?!?!?!
Post by: Hellraiser on August 09, 2010, 10:54:04 am
60 Minutes did a piece yesterday on current Medicare policies regarding end of life. It was absurd. A 93-year old with cancer and renal disease (among other things) can still get a heart defibrillator put in at huge expense even though he's going to die in a matter of weeks anyway. The waste and mismanagement of the US system will bankrupt us, it's simply not sustainable.

That's actually a rerun.  I saw it the first time around and yes, people's fear of death is costing us about 60 billion a year.  The fact of the matter is no one wants to die, but at some point we have to accept that despite all our medical miracles some people can't be brought back from the brink.  It's a waste of resources, and frankly it seems torturous to keep someone alive via machines for the last week to six months of their lives when they are not conscious.  It's selfish and somewhat barbaric, but saying that will get you accused of supporting death panels rather than supporting rational thought when it comes to the end of your time here on the planet.
Title: Re: $1,600 for Atripla ?!?!?!
Post by: RapidRod on August 09, 2010, 11:43:53 am
That's actually a rerun.  I saw it the first time around and yes, people's fear of death is costing us about 60 billion a year.  The fact of the matter is no one wants to die, but at some point we have to accept that despite all our medical miracles some people can't be brought back from the brink.  It's a waste of resources, and frankly it seems torturous to keep someone alive via machines for the last week to six months of their lives when they are not conscious.  It's selfish and somewhat barbaric, but saying that will get you accused of supporting death panels rather than supporting rational thought when it comes to the end of your time here on the planet.
I don't want our government or doctors hired by our government to say who lives and who dies.
Title: Re: $1,600 for Atripla ?!?!?!
Post by: hotpuppy on August 09, 2010, 12:52:04 pm
Husband's Atripla is $1844.00 per month. $1600.00 is about what it was  in early 2008. All our meds together is around $5,700.00 per month.  Thank GOD for insurance.

It's not insurance, it's healthcare.  The sooner people stop seeing as as "insurance" and start looking at it as "healthcare" the sooner we can begin to address the real issues, which are access to drugs and healthcare, not low payments or crappy benefits.

Insurance is a bet you make with an entity.  You bet $x that something will happen, and they bet $XXXX that it won't.  For example, I bet $904 per year that my house will burn down, my insurance company bets $275,000 plus $100,000 contents, plus $10,000 in living expenses that I'm wrong.  If I win they pay out my losses up to $350,000.  If I lose, they keep my $904.

I bet Blue Cross Blue Shield / Texas Risk Pool that I will get sick.  Each month I give them $520.  In return they are on the hook for my meds and doctors visits.  They have a maximum exposure of $2 million.  Pretty crappy bet on their part.  I have some minor risk sharing or co-insurance as well with annual caps in place.

I bet Geico (and their little lizard too) that something bad will happen to my truck.  If it does, they'll replace it, rent me a car, and give me the royal run around trying to catch money tied to the lizards tale.  If I'm wrong, they simply keep my money and use it to fund more executive vacations and commercials.

None of us really want to be with our health or lives.  What we want instead is manageable healthcare costs that have a fixed, predictable rate and don't bankrupt us or force us to choose between being broke and alive or dead.

Title: Re: $1,600 for Atripla ?!?!?!
Post by: hotpuppy on August 09, 2010, 01:00:14 pm
I don't want our government or doctors hired by our government to say who lives and who dies.

I trust you will be leaving shortly then.  Right now the US Government already runs healthcare.

Medicare/Medicaid/chip/adap and it's various incarnations including US Gov't Employees Insurance Co-Operative represent the single largest consumer of medical products in the world.  As such they have the largest baragaining power.  They dictate (more or less) what margins the various vendors in the medical world will operate at for their transactions.

Everyone else (roughly 40% of the US Market) frequently benchmarks on the US Govt (aka Medicaid/Medicare) rates.  So an insurance company might make a doctor agree to accept 110% of the Medicaid rate for office visits.  Individual doctors have very little say in what they are paid unless you happen to be uninsured and rich.  Of course they can opt out completely, but that is economic suicide and doctors are a business at the end of the day.

The only people who get screwed in this system are the uninsured and the underinsured who work and make more than $30,000/yr in the US.  The working poor have County Hospitals and low cost community healthcare. 

So at the end of the day, what care you can and can't receive is largely dictated by people who work for the Congressional Budget Office and Insurance company statisticians and accountants.  Don't be fooled by commercials, marketing people, or slick salespeople.

ADAP works off the same set of rules that Medicare works off of.  Most ASO's have become Community Healthcare providers in order to gain access to Medicaire/Medicaid dollars that their patients have access to coverage under.

Going back to the OP's question, most areas have organizations like Legacy Healthcare which manages The Assistance Fund and helps un-insured and underinsured people with HIV pay for medication and treatment.  Donating as little as $50 can help buy non-HIV meds for someone who has HIV and can help pay for HIV meds when needed.  In Houston, Legacy Healthcare is the largest ASO.  AIDS Foundation Houston has a better name, but doesn't deliver direct medical services or drugs.  They focus mainly on ex-convicts, the homeless, and single mothers with HIV.  Legacy runs 4 clinics, is a Ryan White provider and administers the Assistance Fund which was once independent.
Title: Re: $1,600 for Atripla ?!?!?!
Post by: hotpuppy on August 09, 2010, 01:08:43 pm
.

And you also know that the USA is hardly the best place to seroconvert, if you factor in the lack of universal health care - and that many countries do have universal health care and the cost of HIV medicine doesn't have the overwhelming stressful presence it seems to have, or have had to date, for those with HIV in the USA.

Most "civilized" countries pay for medicine with a 20% tax on earnings.  It's not called out explicitly, but that is the difference in the effective tax rates between here and there.  So, as with all things, there is no free lunch.  Not even the French have figured out how to get free lunch, and they try the hardest with a 34 hour work week, 8 weeks of vacation, and a myriad of social welfare programs.

So in the end it comes down to cost.... my insurance and out of pocket is less than the 20% it would cost me in Canada, the UK, or the EU.  As always, I'm better at managing my money on me then the government is at managing other peoples money on someone else (which is their perspective).

The pharmacist was really cool. When I first filled my HAART prescriptions, I was worried about "what ifs" - what if I lose some. What if I need to travel. What if what if.  She said "we are not counting pills here, if you need medicine come and get it".  

We are not all so lucky and I would suggest that you thank your spiritual entity.  Christans are fond of saying "But for the grace of God there go I." Regardless of your position on religion, I think we can all agree that it is a nice way of acknowledging ones situation and being thankful for it.

Title: Re: $1,600 for Atripla ?!?!?!
Post by: leese43 on August 09, 2010, 04:01:34 pm

So in the end it comes down to cost.... my insurance and out of pocket is less than the 20% it would cost me in Canada, the UK, or the EU.  As always, I'm better at managing my money on me then the government is at managing other peoples money on someone else (which is their perspective).


That's not quite right... for the UK at least. We pay 20% tax but this is not just for healthcare, it also covers our armed forces, police force, fire brigade..basically all public services. I'm sure you must be taxed for these things also?

Leese
Title: Re: $1,600 for Atripla ?!?!?!
Post by: wtfimpoz on August 09, 2010, 04:42:13 pm
I don't want our government or doctors hired by our government to say who lives and who dies.

So you prefer a system where insurance bureaucrats with an eye towards their quarterly bonuses make these decisions instead?
Title: Re: $1,600 for Atripla ?!?!?!
Post by: AaronbytheC on August 09, 2010, 08:20:38 pm
That's not quite right... for the UK at least. We pay 20% tax but this is not just for healthcare, it also covers our armed forces, police force, fire brigade..basically all public services. I'm sure you must be taxed for these things also?

Leese

We do, but it's through a few sources depending where you live in the USA...  Here in California we pay Federal income tax (10% to 35%, depending on your income), State income tax (10%), property tax (roughly 1.2% of our property's assessed value every year, so a $500,000 house would be about $6000 a year), and sales tax 8.75%!  

When you add it all up 20% doesn't look so bad!   ::)
Title: Re: $1,600 for Atripla ?!?!?!
Post by: Miss Philicia on August 09, 2010, 08:39:29 pm
So you prefer a system where insurance bureaucrats with an eye towards their quarterly bonuses make these decisions instead?

I sure don't -- when viral load testing was first FDA approved in 1996 it took close to an entire fucking year for my HMO (which wasn't a shoddy cheap one either) to approve it for me, and only after my doctor was persistent with letters stating it was medically necessary.  By the time I got my first results I could have switched meds around an perhaps no developed the drug resistance that saddled me for another decade after that.
Title: Re: $1,600 for Atripla ?!?!?!
Post by: RapidRod on August 09, 2010, 09:06:41 pm
So you prefer a system where insurance bureaucrats with an eye towards their quarterly bonuses make these decisions instead?
It would be a lot easier to fight with insurance companies then it would be with the government bureaucrats.
Title: Re: $1,600 for Atripla ?!?!?!
Post by: madbrain on August 09, 2010, 09:10:53 pm
Oh, but wait! If a person takes a combination like mine, which is Norvir boosting Prezista, Isentress and Truvada, that price goes up considerably. The pharmacy I attend is kind enough, every month, to put the "retail price" on my medical bottles:
Truvada: US $350 per 30 day supply

Only $350 for Truvada ? Drugstore.com says $1071 . Costco says $1102 .
Title: Re: $1,600 for Atripla ?!?!?!
Post by: jkinatl2 on August 09, 2010, 10:00:06 pm
Only $350 for Truvada ? Drugstore.com says $1071 . Costco says $1102 .


Thats what I have on my Walgreens bag.
Title: Re: $1,600 for Atripla ?!?!?!
Post by: LoboDog on August 09, 2010, 10:04:16 pm
Reading this tread I sense the futility of our situation and the frustration. It was mentioned that those of us with the ability to do something, need to do so. The question then is what???

The drug companies are not going to arbitrarily lower prices. Unfortunately our society is built on building a better mouse trap so I don't think the patent laws will be changed any time soon. We are stuck with high price meds no matter how you see it.... Unless one of 2 things happens. A philanthropical org develops the next great drug and sells it at cost or we find a cure.

The drug companies are not going to be looking for a cure any time soon. We are their cash cow. They have spent their money on research, found a great drug, and are going to get as much out of those drugs as possible. They want their annual bonus.

We need to support the orginizations looking for a cure. Primarily this group is made up of gay men. We have disposable income. Without kids we have disposable time. We need to be our own advocates in make the meds obsolete.

To be honest, I can't think of a single group that is doing HIV research with an aim at the cure. Are they still working on vaccines? Are they any organizations set up to insure the researchers are adequately funded?
Title: Re: $1,600 for Atripla ?!?!?!
Post by: leatherman on August 09, 2010, 10:10:13 pm
Only $350 for Truvada ? Drugstore.com says $1071 . Costco says $1102 .
medicare (thru community ccrx) along with SC medicaid pay $990.55 a month for my Truvada
a monthly supply of Norvir is $274.87
Title: Re: $1,600 for Atripla ?!?!?!
Post by: BlueMoon on August 09, 2010, 10:13:55 pm
Only $350 for Truvada ? Drugstore.com says $1071 . Costco says $1102 .



Medco says $1032.  What a deal!

My entire regimen is $3200 a month.  At that price $1600 for Atripla is a steal.
Title: Re: $1,600 for Atripla ?!?!?!
Post by: dvinemstre on August 10, 2010, 12:36:42 am
ok so a couple of things about this information in the thread: when you get your medication at a pharmacy and you have some form of prescription medication coverage in the US, the copayment is there and the "price" which is the negotiated price the pharmacy and the insurance company have agreed for the med. For example, drug B is 30$ copay and the "price" listed is $150. This does not mean that the price for an uninsured person would be $150, it means that the insurance company has agreed to pay that amount to the pharmacy for filling their subscribers medications there. It is in the best interest of pharmacies to negotiate low prices, hence the disappearance of the family or local pharmacy in most places in the US. Secondly, not sure what being 55 has to do with anything, but at present the requirement to getting Medicare is one must either be declared "disabled" by the SSA and then wait two years for medicare, or qualify for medicaid based on income level. However, unless you have been deemed disabled by the SSA you can not get adult medicaid. this means you have to have children living home or other things in order to get the insurance. HOWEVER, due to the health care bill that passed in March 2010, ALL states have a high risk pool. Being HIV + is ONE of the many high risk health qualifiers for the subsidized insurance. you can go to the healthcare .gov website, click on your state and see your state's options. Then, based on income, you may also receive a subsidy for your monthly premium. For example, I would pay $1200 monthly with a 5K deductable through Blue Cross Blue Shield from private insurance, and I'm not even on meds yet. However, with the high risk pool I would only pay $340 monthly with a 1K deductable. Also, by spring 2014, a person with HIV+ diagnosis, regardless of health condition, will be eligible for Medicaid under certain guidelines. Lastly, if you are working, you can also apply to your local State Vocational Rehabilitation Agency and they could assist with med costs and other costs in order for you to maintain employment. Even if you make pretty good income, the qualifying amount is figured and then your income and then this voodoo number is derived which is like a deductable. I hope this makes it clearer...this is something I do professionally in terms of benefits and advocacy. Z
Title: Re: $1,600 for Atripla ?!?!?!
Post by: Inchlingblue on August 10, 2010, 07:55:46 am
 However, unless you have been deemed disabled by the SSA you can not get adult medicaid.

Medicaid eligibility varies by State. I know someone who qualifies solely because of low income. He is a single adult who is not disabled and has HIV. He makes very little money and in his state he qualifies for full Medicaid. Not every state works that way, though. 

What I don't understand about the high risk pools is that they require that a person be turned down for regular health insurance and then wait 6 months. Why do they make people with pre-existing conditions wait 6 months with no insurance before they are eligible for the high risk pool? This makes no sense to me. These are people for whom 6 months can mean the difference between life and death, between getting sick and staying healthy. Why do these policies always seem to have some sort of technicality that makes things harder on those most in need?

Title: Re: $1,600 for Atripla ?!?!?!
Post by: RapidRod on August 10, 2010, 08:13:42 am
My Atripla is 1496 per month but my noxafil is 8370 a month for 630 ml. 6.00 co-pay. That's just two of the medications I take.
Title: Re: $1,600 for Atripla ?!?!?!
Post by: dvinemstre on August 11, 2010, 12:35:10 am
it is my understanding that a person has to have been without insurance for 6 months, not wait 6 months after they apply.
Title: Re: $1,600 for Atripla ?!?!?!
Post by: Inchlingblue on August 11, 2010, 08:48:31 am
it is my understanding that a person has to have been without insurance for 6 months, not wait 6 months after they apply.

This is the way I understand it, and I would like nothing more than to be wrong about this:

A person must show that they were denied insurance and then wait six months. If that person didn't have insurance to begin with, it's six more months of no insurance. If the person had insurance from their job, for example and lost it, they must apply for regular coverage and be denied  and then wait six months before they qualify for the high risk pool.

Any way you slice it's a six month waiting period with no insurance, which is what I don't understand.

Why can't someone with a PEC just be able to go ahead and join the high risk pool without having to wait six months without coverage?

Eligibility

In order to receive insurance through the temporary high risk pool program, an individual must meet the criteria established in the law. Eligible individuals must:

Be a citizen or national of the United States or lawfully present in the United States;

Not have been covered under creditable coverage (as defined in Section 2701(c)(1) of the Public Health Service Act) for the previous 6 months before applying for coverage; and

Have a pre-existing condition, as determined in a manner consistent with guidance issued by the Secretary.

LINK:

http://www.hhs.gov/ociio/initiative/hi_risk_pool_facts.html

The above excerpt does not go into the fact that one has to prove one was denied coverage but it's in other parts of the literature for the new plan:

How to Apply in States Where the Pre-Existing Condition Insurance Plan is Run by the U.S. Department of Health and Human Services

If the Pre-Existing Condition Insurance Plan in your state is run by the U.S. Department of Health and Human Services, just log on to www.healthcare.gov to apply.  You will be linked directly to the application page.  Or you can call 1-866-717-5826 (TTY 1-866-561-1604) and ask for an application.

To apply, you will need at a minimum:

A completed and signed application form.

A copy of a letter dated within 6-months of your application from an insurance company or health plan showing that you have been completely denied individual coverage because of a pre-existing condition, or you were offered coverage but were denied certain benefits (for example, by a rider to an insurance policy) because of a pre-existing condition

LINK:

http://www.healthcare.gov/law/provisions/preexisting/federal/index.html
Title: Re: $1,600 for Atripla ?!?!?!
Post by: David_CA on August 11, 2010, 09:14:39 am
My insurance uses Medco for its drug benefits.  Sometime last year (I believe, may have been the year before), I noticed that my insurance was being charged around $2700 for 1 month's amount of Atripla.  Although $1600 is a lot, it is 3 drugs that would cost more separately.  I don't mean to trivialize the cost at all, but it's a cheaper co-pay than regimens with 2-3 separate drugs.
Title: Re: $1,600 for Atripla ?!?!?!
Post by: bufguy on August 13, 2010, 11:06:12 am
I have Medco through Blue Cross/ Blue Shield and thet pay approximately $1600.00 per month. My copay is $10
Title: Re: $1,600 for Atripla ?!?!?!
Post by: Florida69 on August 18, 2010, 09:06:32 am
It is a good thing you guys have good insurance.  I have blue cross blue shield of Florida and my co pay, what I pay out of pocket for Sustiva and Epzicom is around $600.00.  I work 2 jobs just so I can afford my medications... If I did not have any insurance at all it would cost around $1,500.00 per month...
Title: Re: $1,600 for Atripla ?!?!?!
Post by: Hellraiser on August 18, 2010, 10:04:20 am
It is a good thing you guys have good insurance.  I have blue cross blue shield of Florida and my co pay, what I pay out of pocket for Sustiva and Epzicom is around $600.00.  I work 2 jobs just so I can afford my medications... If I did not have any insurance at all it would cost around $1,500.00 per month...

You should look into manufacturer assistance for those copays, you might could save a LOT of money if you just fill out the proper paper work.
Title: Re: $1,600 for Atripla ?!?!?!
Post by: Inchlingblue on August 18, 2010, 11:57:15 am
Yes, Trey makes a very good point, you could save hundreds of dollars a month. I use the copay assistance for Isentress and for Truvada, they are very easy to use, not any paperwork actually. You call the 800 number and they ask you a few questions.

The link below has the contact info on each program.

The info for Atripla is dated, this is the update:

Effective on or before July 1, 2010, Gilead will eliminate the requirement for clients with private insurance to pay the first $50 of out-of-pocket expenses before co-pay assistance begins. Going forward, Gilead will pay up to $200 per month ($2,400/year) toward out-of-pocket expenses for Truvada, Viread or Emtriva. All clients in the U.S. with private insurance are eligible, except where prohibited by law. Clients seeking further information on Gilead's co-pay program should call 1-888-358-0398 to request a pharmacy Co-Pay Card for use when filling prescriptions.

LINK:

http://www.hivandhepatitis.com/recent/2010/0608_2010_e.html

LINK WITH CONTACT INFO:

http://www.thebody.com/content/art51554.html
Title: Re: $1,600 for Atripla ?!?!?!
Post by: BlueMoon on August 18, 2010, 08:24:10 pm
Yes!  Apply for copay assistance!  It got my $711 a month meds tab down to $62.  That's a second job right there.
Title: Re: $1,600 for Atripla ?!?!?!
Post by: Granny60 on August 18, 2010, 11:08:02 pm
A little clarification here. SSDI is Social Security Dissability.  If you have SSDI you can apply for medicare after a two year wait.  SSI is Supplemental Security Income.  If your SSDI is too little or if you do not qualify for  SSDI such as a stay at home mom that did not work enough quarters, you may get SSI.  You cannot get Medicare  if you only get SSI until you turn 65.  If you have SSDI and Medicare,  you can also have Medicaid in some states to help with  the co pays, part D, etc.  As to fighting the thieving insurance company or government bureaucrats, Today a sweet lady from Medicaid got on the phone and fought my husbands insurance company like a tiger trying to help him out.  It was the only heartwarming part of our  entire day except for feeding the goldfish.
Title: Re: $1,600 for Atripla ?!?!?!
Post by: Granny60 on August 18, 2010, 11:59:46 pm
Today picked up the meds that were ready for pickup.  here are some prices from today's bills
Cialis 5 mg. 30 pills $123.51 ( had a discount coupon)
Fexophenadine 180 mg  $55.99
Omnaris $109.49
Ambien Cr. $194.49
Metoprolol 50 mg$ 4.00
Atripla $1844.99
Proair HFA $46.99
Estrace Creme $155.99
Pentoxifyline  400 mg $ 49.19
Acetyl Carnitine 1000 mg $33.28
Azelast Nasal spray 137 MCG  $86.99
Combivir $1024.49
Reyataz 300MG $1116.99
Norvir 100 MG $337.49
Pataday .2% $111.49
Zolpedem 5 mg $47.99
Levothroxin 50 MCG  $4.00
Amitriptyline 25 mg $4.00
Advair Diskus 250/50 $230.99
Total                       $ 5,581.85 that's $66,982.20 per year for 2 people.  Then there is insurance and doctors/ lab expenses. enough to make you have to call the paramedics to come haul your azz away.
Clearly shows why drug assistance and or insurance is a must. Out of pocket cost $300.78
All in US. $ and not even all our meds.
Title: Re: $1,600 for Atripla ?!?!?!
Post by: Inchlingblue on August 19, 2010, 12:39:25 am
Granny60 - wow!~
Title: Re: $1,600 for Atripla ?!?!?!
Post by: BigDaneDogs on May 09, 2011, 07:49:09 pm
ADAP is going to be your best bet.  They can keep you alive but you are GOING TO PAY!!!!.  I think my totals right now between 8 - 10 drugs is about $40000.00 per month.  If it weren't for ADAP and the pharmacutical programs, me and my big-ass dogs would be living under a bridge somewhere and we'd ALL be eating puppy chow.  :P
Title: Re: $1,600 for Atripla ?!?!?!
Post by: metekrop on May 10, 2011, 04:26:30 pm
:o
.....She then told me it was $1,600 for 30 pills.  Really.

I don't think so.  Mine costs like $2230 for 30 pills a month.  I see this figure on the receipt attached to the meds they deliver me.  Actually my cost is only $30.
Title: Re: $1,600 for Atripla ?!?!?!
Post by: Gio on May 10, 2011, 05:02:00 pm
OK would someone like to explain to me why the cost of Atripla went up by almost $500 for a 30 day supply?  my insurance pays for it an no copay but my god it if was not for insurance i would be broke broke broke..  ARRGGHH!!
Title: Re: $1,600 for Atripla ?!?!?!
Post by: Raf on May 10, 2011, 05:09:10 pm
Ugh..more than 1000 bucks for Combivir back in 2010 (one of the meds I take, I don't know the cost of kaletra yet)...I would be ruined if I were to buy these meds.I'm afraid that I'll be stuck here in my country the rest of my life because I don't see myself paying for them in another country (In my country I get them for free, and I'm really thankful of that, in fact, It's the only damn thing that my government did right).