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Author Topic: Living overseas, uninsured.. Treatment options?  (Read 9132 times)

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Offline LordBerners

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Living overseas, uninsured.. Treatment options?
« on: March 07, 2010, 01:44:13 PM »
I'm living in Thailand and coming to the end of my first couple of years of ARV, which so far I have gotten free under a study.  I've been told I will have to change one of my meds as it is not currently commercially available in Thailand (I'm currently on tenofovir, Reyetaz(atazanavir), Abacavir, and Norvir and they propose changing the Abacavir to AZT).  Even under this new regimen I would have to pay about $600/month for my drugs, more than I can afford on my $1,200/month teaching income.

I love my job and life here in Thailand and don't wish to live in the USA..   I was wondering - and I apologize if this idea is illegal or against the rules - could I get on ADAP in my home state and still live here most of the year?  I ask because $600/month is $7,200/year which would easily pay for visits home for checkups and so forth every six months (I already go home once a year to visit aged parents).  I'm sure my income of about $15,000 a year here qualifies as poverty level back home (and its not that much here either) so I wouldn't be violating that rule of eligability, but I'm wondering about residency requirements, etc.  Anyone know?
Please, just call me Berners.. or Baron.

Offline Miss Philicia

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Re: Living overseas, uninsured.. Treatment options?
« Reply #1 on: March 07, 2010, 02:01:46 PM »
could I get on ADAP in my home state and still live here most of the year?

no
"Iíve slept with enough men to know that Iím not gay"

Offline bear60

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Re: Living overseas, uninsured.. Treatment options?
« Reply #2 on: March 07, 2010, 02:02:25 PM »
I dont think you understand ADAP.  It doesnt pay $$ to you directly.  The program pays your pharmacy.  (At least here in PA.)
Unless I missed something in your post, there is no way you can get your drugs from the states while living in Thailand.  Did you intend to have them shipped from the states?  If I read your post correctly, you come to the USA on occasion but thats not enough to get meds on a monthly basis.
And believe me, they dont give out 6 months supply.
Poz Bear Type in Philadelphia

Offline LordBerners

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Re: Living overseas, uninsured.. Treatment options?
« Reply #3 on: March 07, 2010, 02:23:36 PM »
I dont think you understand ADAP.  It doesnt pay $$ to you directly.  The program pays your pharmacy.  (At least here in PA.)
Unless I missed something in your post, there is no way you can get your drugs from the states while living in Thailand.  Did you intend to have them shipped from the states?  If I read your post correctly, you come to the USA on occasion but thats not enough to get meds on a monthly basis.
And believe me, they dont give out 6 months supply.

Oh I see, they give them out on a monthly basis?  Here the norm seems to be every 3 months though one typically only has actual checkups every 6.

I had imagined that they dispensed the medicines from some government pharmacy either by having you pick them up or by mailing them to you.

What I'm getting from you guys is that my physical presence would be demanded once a month.
« Last Edit: March 07, 2010, 02:27:07 PM by LordBerners »
Please, just call me Berners.. or Baron.

Offline Ann

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Re: Living overseas, uninsured.. Treatment options?
« Reply #4 on: March 07, 2010, 02:45:16 PM »
LB,

You would be committing fraud. It's that simple.
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Offline mecch

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Re: Living overseas, uninsured.. Treatment options?
« Reply #5 on: March 07, 2010, 03:32:11 PM »
Why is it fraud if an American citizen gets benefits abroad? I see that its not possible, but fraud???  Europeans get their health benefits abroad, don't they?
« Last Edit: March 07, 2010, 03:35:51 PM by mecch »
ďFrom each, according to his ability; to each, according to his needĒ 1875 K Marx

Offline Inchlingblue

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Re: Living overseas, uninsured.. Treatment options?
« Reply #6 on: March 07, 2010, 03:41:50 PM »
If I were you I'd look up what the eligibility requirements are for being considered a resident of your particular state since to qualify for ADAP a person must be a resident of the state in question. There may be some provision for working overseas while still being a resident of the state, you never know.

Have you looked at ASOs in Thailand through aidsmap (link below) to see if there are any resources in Thailand that you may not be aware of? Have you been in contact with Thai Network for People Living with HIV/AIDS?

LINKS:

http://aidsmap.com/cms1038779.asp

http://www.hivpolicy.org/biogs/HPE0235b.htm

 

Offline Miss Philicia

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Re: Living overseas, uninsured.. Treatment options?
« Reply #7 on: March 07, 2010, 03:47:11 PM »
Good luck showing the state department of health a copy of your electrical utility bill for residency proof on that one, inchling.
"Iíve slept with enough men to know that Iím not gay"

Offline Inchlingblue

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Re: Living overseas, uninsured.. Treatment options?
« Reply #8 on: March 07, 2010, 04:00:32 PM »
It's possible to get generic HIV drugs online. Those made by Cipla are reliable. Have you checked if it would be cheaper than $600/month to order them online?

LINKS:

http://www.globalpharmacycanada.com/

http://www.inhousepharmacy.com

http://www.aids-drugs-online.com/

Offline azprince

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Re: Living overseas, uninsured.. Treatment options?
« Reply #9 on: March 07, 2010, 04:52:44 PM »
It's possible to get generic HIV drugs online. Those made by Cipla are reliable. Have you checked if it would be cheaper than $600/month to order them online?

LINKS:

http://www.globalpharmacycanada.com/

http://www.inhousepharmacy.com

http://www.aids-drugs-online.com/
Even though I was a big fan of the idea of using generic Atripla, my doctor was totally against the idea!? I dont understand if this is just because of commercial support reasons that Doctors are committed to or if there is a scientific reason behind it, when I pushed him to tell me his reasons he said that he can only trust FDA meds even if he is sure that the generic atripla is the same as the one I am currently using, which didnt make a lot of sense for me  ??? I would switch the generic ones if I had to live abroad with out being hesitant...is there any evidence or research on the generic atripla? can you refer me to it please
I have to admit : the good thing is that from now on;  I have no option but to succeed , still its ok to worry :))

Offline RapidRod

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Re: Living overseas, uninsured.. Treatment options?
« Reply #10 on: March 07, 2010, 05:05:54 PM »
Even though I was a big fan of the idea of using generic Atripla, my doctor was totally against the idea!? I dont understand if this is just because of commercial support reasons that Doctors are committed to or if there is a scientific reason behind it, when I pushed him to tell me his reasons he said that he can only trust FDA meds even if he is sure that the generic atripla is the same as the one I am currently using, which didnt make a lot of sense for me  ??? I would switch the generic ones if I had to live abroad with out being hesitant...is there any evidence or research on the generic atripla? can you refer me to it please
There is no generic Atripla that is legal.

Offline LordBerners

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Re: Living overseas, uninsured.. Treatment options?
« Reply #11 on: March 07, 2010, 05:09:57 PM »
I didn't mean to create a controversy, and as I mentioned in the original post I apologized in advance if what I was considering was illegal or against the rules.  I couldn't really know whether it was or was not without asking.

As for hiv services in Thailand - those are for Thais, I believe, not foreigners. 

Regarding the generic drugs, I would most certainly trust them, but I am not sure if they're available here.  Basically in this country drugs are much cheaper than in the US for a variety of reasons, including in a few cases the Thai government (quite bravely in my opinion) breaking patents, and in other cases just pressuring the maker to lower the price.  But whether these are still from the original companies or whether really cheap generics are available I don't know - presumably legality depends on the country.

 I actually thought $600/month sounded very cheap, just a lot more than I have.

Lastly:
Why is it fraud if an American citizen gets benefits abroad? I see that its not possible, but fraud???  Europeans get their health benefits abroad, don't they?

Oh, you know, America is very different from Europe.  I won't cry about it here, but I'm sure you can imagine how much I envy you, mecch.
Please, just call me Berners.. or Baron.

Offline LordBerners

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Re: Living overseas, uninsured.. Treatment options?
« Reply #12 on: March 07, 2010, 05:17:57 PM »
LINKS:

http://www.globalpharmacycanada.com/

http://www.inhousepharmacy.com

http://www.aids-drugs-online.com/

Thanks, Inchling.. at the first and third sites I found some interesting (perhaps promising?) results, but no results at the second.  Tenofovir generics seemed to be roughly the same or slightly more expensive than Thai sources have quoted me, but Abacavir (Ziagen) and Atanazavir (Reyetaz) generics did seem quite a lot cheaper, so this gives me some feeling of hope as those were the two that made up the bulk of the cost here in Thailand (about $300/month each).
« Last Edit: March 07, 2010, 05:19:43 PM by LordBerners »
Please, just call me Berners.. or Baron.

Offline Inchlingblue

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Re: Living overseas, uninsured.. Treatment options?
« Reply #13 on: March 07, 2010, 07:11:57 PM »
There is no generic Atripla that is legal.

I think what you might mean is that it's not legal to sell generic Atripla in the US. There is generic Atripla called Viraday which is legally sold and used in many countries throughout the world. If a person in the US wanted to buy it online for personal use it might not be legal but I doubt that anyone would press charges.

atripla vis viraday

Feb 6, 2010
i am now taking atripla but because of the cost im considering viraday. im worried about the safty and reliablty and dosage of viraday. can i consider changing meds to save money.

Response from Dr. Young

Hello and thanks for your post.

Viraday is a generic version of Atripla, manufactured by Cipla in India. The two contain the same medications (tenofovir, FTC, efavirenz) and can generally be assumed to be safe and reliable. The key issue is who is the provider of the Viraday and depending on which country you live in, importation of the medication might be in violation of statutes.


LordBerners:  Before buying generics, I'd make sure to find out who manufactures the drug. If it's Cipla then it's fine, they're a reputable company. If it's someone else, I'd research and make sure.

The first two online pharmacies I posted were mentioned by forum members who have used them and said they were reliable. The third one is one I saw online but don't have any specific info. about it.

A while back I came across something that rated the reliability of online pharmacies, if I can find it I'll send it along.

Offline hollyavila

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Re: Living overseas, uninsured.. Treatment options?
« Reply #14 on: March 07, 2010, 09:32:44 PM »
I have to wait for a year to get ADAP in the US. You have to live in the state. If you health is that important to you then you need to move to the US. If not then your country you reside will need to take care of you. Why should we have to pay for your meds. Our census provides funding and if you are abroad then you have not been included in our count for funding and if you get the US ADAP you are taking from someone that has been accounted for and someone that is here in the US. ADAP has waiting lists.  You don't want to be here but you want the benefits from the US. That is illegal and it is WRONG!!!!

Offline Inchlingblue

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Re: Living overseas, uninsured.. Treatment options?
« Reply #15 on: March 07, 2010, 10:56:31 PM »
I have to wait for a year to get ADAP in the US. You have to live in the state. If you health is that important to you then you need to move to the US. If not then your country you reside will need to take care of you. Why should we have to pay for your meds. Our census provides funding and if you are abroad then you have not been included in our count for funding and if you get the US ADAP you are taking from someone that has been accounted for and someone that is here in the US. ADAP has waiting lists.  You don't want to be here but you want the benefits from the US. That is illegal and it is WRONG!!!!

He understands that he cannot get ADAP while living in Thailand. He will be losing access to the medications in a few months and was simply asking if ADAP might possibly be an option. If I were in his shoes I would also be looking at every possible option, regardless of how remote. He is an American citizen and happens to be living abroad. He has every right to move back to the US if he wants to.

There's really no need for your angry and judgmental diatribe.


Offline sanitex

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Re: Living overseas, uninsured.. Treatment options?
« Reply #16 on: March 07, 2010, 11:38:27 PM »




hello lordbenner,i do understood your problem but my advice to you is ,could you
ask your ID doc to give you a prescription paper from him so that you can buy most of the medications
from (annoymous clinic) here where most of those meds is very cheaper.because this's  how i bought
mine and even check my lab result as well at the rate of (2000 baht 60usd)here are the prices
Updated Prices of ARVs at Thai Red Cross Clinic Nov 2009:

1.ABC (Ziagenavir) 300mg 60 tablets 8490 THB
2.ATZ " REYATAZ 200mg 60 tablets 9750 THB
3.ATZ '' REYATAZ 300mg 30 tablets 8640 THB
4.Darunavir " PREZISTA 300mg 120 tablets 13800 THB
5.DDI " VIDEX*EC 250mg 30 tablets 2430 THB
6.DDI " VIDEX*EC 400mg 30 tablets 3750 THB
7.EFV " STROCIN 600mg 30 tablets 810 THB
8.IDV (CRIXIVAN) 180 tablets ราคา 2160 THB
9.3TC " LAMIVIR 60 tablets 570 THB
10. 3TC " LAMIVIR 30 tablets 570 THB
11.LPV/RTV " Aluvia 60 tablets 1440 THB
12.LPV/RTV " Kaletra 180 tablets 5400 THB
13.NVP " NERAVIR 60 tablets 960 THB
14.RTV " Norvia 84 tablets 3024 THB
15.SQV " Invirase 120 tablets 9360 THB
16.D4T " STAVIR 60 tablets 240 THB
17.TDF " Viread 30 tablets 1350 THB
18.AZT " ANTIVIR 100 tablets 650 THB
19.3TC+AZT " Zilavir 60 tablets 1230 THB
20.3TC+NVP+D4T" GPO vir S-30 60 tablets 990 THB
21.3TC+NVP+AZT ''GPO vir Z-250 60 tablets 1320 THB 
     
 i hope this will help thanks san

27/12/07 cd4 20 vl 1million
10/4 /08 cd4 86 vl 63
1/7/08  cd4 186 vl undetectable
16/10/08 cd4 196 vl undet
23/1/09 cd4 248 vl un
10/9/11 cd4 418 vl <40 %22
13/12/11 cd4 410 vl undet 23%
24/2/12 cd4 545 vl undet 26%
on 22/2/12 change truvada to Recovir-EM
due to no stock on Truvada.
10/9/11 cd4 418 vl <40 %22
7/7/12 cd4 359 vl <40 22%
23/8/12 cd4 400 vl <40 23%,
testosterone test 7.5 ng/ml and
thyroid (TSH)1.32 ulu/ml creatinine.eGFR blck 1.5 all fasting test morning.
13/12/2012 cd4 523 24% vl <40
18/3/2013 cd4  513  23% vl <40
regimen ATRIPLA
03/8/2013 cd4 429 22% vl <40
13/11/2013 cd4 455 23% vl <40
Anti-HBs test (quantitative ) Anti-HBs positive
Titer 16.95 mlu/ml <10.00
22/3/14 cd4 396 vl <40 % 24

Offline azprince

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Re: Living overseas, uninsured.. Treatment options?
« Reply #17 on: March 07, 2010, 11:56:09 PM »
There is no generic Atripla that is legal.
what about "Viraday"?
http://www.aids-drugs-online.com/productdetails.php?id=Viraday

I thought the patent doesnt run in India thus it could have a generic version?
I have to admit : the good thing is that from now on;  I have no option but to succeed , still its ok to worry :))

Offline aztecan

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Re: Living overseas, uninsured.. Treatment options?
« Reply #18 on: March 08, 2010, 12:43:03 AM »
what about "Viraday"?
http://www.aids-drugs-online.com/productdetails.php?id=Viraday

I thought the patent doesnt run in India thus it could have a generic version?

Unless the company has made some special arrangement with the developers of Atripla, then the maker of the generic is flouting international law.

The patent on Atripla won't run out for many years yet. The only legal generics are those of drugs from the first line, such as AZT, the generic of which is called Retrovir.

Just saying,

HUGS,

Mark
« Last Edit: March 08, 2010, 12:45:59 AM by aztecan »
"May your life preach more loudly than your lips."
~ William Ellery Channing (Unitarian Minister)

Offline LordBerners

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Re: Living overseas, uninsured.. Treatment options?
« Reply #19 on: March 08, 2010, 04:53:54 AM »
...you can buy most of the medications
from (annoymous clinic) here where most of those meds is very cheaper.because this's  how i bought
mine and even check my lab result as well at the rate of (2000 baht 60usd)here are the prices
Updated Prices of ARVs at Thai Red Cross Clinic Nov 2009:

1.ABC (Ziagenavir) 300mg 60 tablets 8490 THB
3.ATZ '' REYATAZ 300mg 30 tablets 8640 THB
14.RTV " Norvia 84 tablets 3024 THB
17.TDF " Viread 30 tablets 1350 THB

Thank you so much, sanitex, for this information.  Actually this was the source I was considering for my meds, and the price that my doctors guessed at off the top of their heads was 20,000 baht per month (I added the above figures up and it was about 19,500, so about the same). The docs had suggested changing the ABC (Ziagenavir) to AZT as a money saving move, as that one is much cheaper.. but I have my doubts about AZT.  Changing to the AZT takes the monthly cost down to about 12,000 baht or $380.

19,500 baht is about $600, so, yes it is very cheap, but I think it may be impossible to afford on my $1,200/month income.  (as you may know the typical foreign teacher's income here is about $1,000/month, so I'm actually very lucky).   So, even at the cheaper prices I don't think I could buy those meds from that clinic..

Its a bit of a conundrum, of course.  The only problem with moving home is I would immediately face unemployment and poverty, though I might be able to get the ADAP, while here I have a very satisfying and worthwhile life but can't afford the medicines. 

Lastly, regarding the 'flaunting of international law' by making cheaper generics - I think this is the policy of a number of nations, based on humanitarian necessity (namely India, Brazil, Thailand), rather than just the policy of some rogue drugs company.
Please, just call me Berners.. or Baron.

Offline joemutt

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Re: Living overseas, uninsured.. Treatment options?
« Reply #20 on: March 08, 2010, 05:26:55 AM »
another solution would be to use the social security that comes with your job.
that would allow you to benefit from 2nd and 3rd lines of treatment at very little cost.
i have sent you the protocol for that in a pm a month ago, it's of course your call to take that
avenue but it absolutely exists.


Offline LordBerners

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Re: Living overseas, uninsured.. Treatment options?
« Reply #21 on: March 08, 2010, 05:40:32 AM »
another solution would be to use the social security that comes with your job.
that would allow you to benefit from 2nd and 3rd lines of treatment at very little cost.
i have sent you the protocol for that in a pm a month ago, it's of course your call to take that
avenue but it absolutely exists.

Thank you, but my Thai confidante suggests that the school would almost certainly find out about it and would almost certainly let me go (or even if I was fortunate and they did not, the cat would be out of the bag).  There is also an issue that it is probably not even legal for a foreigner with hiv to work in Thailand - you know when you go in for your health check for the work-permit, they ask if you have any chronic or serious diseases..

Sorry to pry, but can I ask if you utilize this option, joemutt?
Please, just call me Berners.. or Baron.

Offline joemutt

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Re: Living overseas, uninsured.. Treatment options?
« Reply #22 on: March 08, 2010, 05:47:19 AM »
I understand, but then it's no longer a mere financial or medical issue and you limit your own options.
Myself I use insurance that comes with my job and I'm out with my hiv in the work place, so no worries there.

ed. sp.error

Offline Miss Philicia

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Re: Living overseas, uninsured.. Treatment options?
« Reply #23 on: March 08, 2010, 09:03:16 AM »
There is also an issue that it is probably not even legal for a foreigner with hiv to work in Thailand - you know when you go in for your health check for the work-permit, they ask if you have any chronic or serious diseases..

You've been infected with HIV for 2.5 years and you don't even know if that's legal or not?
"Iíve slept with enough men to know that Iím not gay"

Offline azprince

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Re: Living overseas, uninsured.. Treatment options?
« Reply #24 on: March 08, 2010, 09:22:43 AM »
I dont think there are any regulations against HIV+ people in thailand, maybe you need to check it, but I do understand the concern, hope you can buy the online generics for cheap prices, it seems the best decision

Good luck
I have to admit : the good thing is that from now on;  I have no option but to succeed , still its ok to worry :))

Offline azprince

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Re: Living overseas, uninsured.. Treatment options?
« Reply #25 on: March 08, 2010, 09:50:27 AM »
You've been infected with HIV for 2.5 years and you don't even know if that's legal or not?
Whats with the attitude? I dont think you need to be addressed like that if you were in his place...some people are infected with HIV for years and still dont know a lot about it , its not a shame to ask, but ignorance and pretending that you know is
I have to admit : the good thing is that from now on;  I have no option but to succeed , still its ok to worry :))

Offline Inchlingblue

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Re: Living overseas, uninsured.. Treatment options?
« Reply #26 on: March 08, 2010, 09:59:31 AM »
Unless the company has made some special arrangement with the developers of Atripla, then the maker of the generic is flouting international law.

The patent on Atripla won't run out for many years yet. The only legal generics are those of drugs from the first line, such as AZT, the generic of which is called Retrovir.

Just saying,

HUGS,

Mark


Mark, they are not "flouting international law." Cipla is a perfectly legitimate and legal enterprise.

Today (2007), Cipla is the world's largest manufacturer of antiretroviral drugs[citation needed] (ARVs) to fight HIV/AIDS, as measured by units produced and distributed (multinational brand-name drugs are much more expensive, so in money terms Cipla medicines are probably somewhere down the list). Roughly 40% of HIV/AIDS patients undergoing antiretroviral therapy worldwide take Cipla drugs.

Indian law from 1972 until 2005 allowed no (end-product) patents on drugs, and provided for compulsory licensing, Cipla was able to manufacture medicines which enjoyed patent monopoly in certain other countries (particularly those where large, multinational pharmaceutical companies are based). By doing so, as well as by making an executive decision not to make profits on AIDS medication, Cipla reduced the cost of providing antiretrovirals to AIDS patients from $12,000 and beyond (monopoly prices charged by international pharma conglomerates) down to around $300 per year. Today they are able to do so for under $150 per patient per year. While this sum remains out of reach for many millions of people in Third World countries, government and charitable sources often are in a position to make up the difference for destitute patients.


LINK:

http://en.wikipedia.org/wiki/Cipla

Offline Inchlingblue

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Re: Living overseas, uninsured.. Treatment options?
« Reply #27 on: March 08, 2010, 10:05:30 AM »

Its a bit of a conundrum, of course.  The only problem with moving home is I would immediately face unemployment and poverty, though I might be able to get the ADAP, while here I have a very satisfying and worthwhile life but can't afford the medicines. 


You would probably qualify for your state's Medicaid (depending on the state and eligibility rules) which would cover more than what ADAP covers. You might want to start the ball rolling trying to establish residency. Maybe you can register to vote using your family's address or if you take a trip back you can get a driver's license or something.

It might not be bad to move back for now and then possibly go back to Thailand at some point in the future.

Offline joemutt

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Re: Living overseas, uninsured.. Treatment options?
« Reply #28 on: March 08, 2010, 10:23:47 AM »
Whats with the attitude? I dont think you need to be addressed like that if you were in his place...some people are infected with HIV for years and still dont know a lot about it , its not a shame to ask, but ignorance and pretending that you know is

hiv is not on the list of diseases that Thai immigration would stop you for :
1. Leprocy
2. Tuberculosis
3. Elephantiasis
4. Drug addiction
5. Third step of Syphilis

Offline aztecan

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Re: Living overseas, uninsured.. Treatment options?
« Reply #29 on: March 08, 2010, 10:33:05 AM »
Mark, they are not "flouting international law." Cipla is a perfectly legitimate and legal enterprise.

Today (2007), Cipla is the world's largest manufacturer of antiretroviral drugs[citation needed] (ARVs) to fight HIV/AIDS, as measured by units produced and distributed (multinational brand-name drugs are much more expensive, so in money terms Cipla medicines are probably somewhere down the list). Roughly 40% of HIV/AIDS patients undergoing antiretroviral therapy worldwide take Cipla drugs.

Indian law from 1972 until 2005 allowed no (end-product) patents on drugs, and provided for compulsory licensing, Cipla was able to manufacture medicines which enjoyed patent monopoly in certain other countries (particularly those where large, multinational pharmaceutical companies are based). By doing so, as well as by making an executive decision not to make profits on AIDS medication, Cipla reduced the cost of providing antiretrovirals to AIDS patients from $12,000 and beyond (monopoly prices charged by international pharma conglomerates) down to around $300 per year. Today they are able to do so for under $150 per patient per year. While this sum remains out of reach for many millions of people in Third World countries, government and charitable sources often are in a position to make up the difference for destitute patients.


LINK:

http://en.wikipedia.org/wiki/Cipla

I know what they are doing, and it may well be legal in India. But CIPLA did not develop the drugs used in their generic Atripla, they incurred no cost from its initial testing or clinical trials, and they are flouting U.S. law.

Granted, they are in India and probably don't give a rat's patoot what U.S. law says, but in my eyes, they are still doing a dishonest thing.

That said, using generic knock-offs may be of benefit to LB, who may find himself repatriated if he cannot find another avenue to obtain his meds.

HUGS,

Mark
"May your life preach more loudly than your lips."
~ William Ellery Channing (Unitarian Minister)

Offline Miss Philicia

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Re: Living overseas, uninsured.. Treatment options?
« Reply #30 on: March 08, 2010, 10:37:15 AM »
You might want to start the ball rolling trying to establish residency. Maybe you can register to vote using your family's address or if you take a trip back you can get a driver's license or something.

Having been on ADAP in two different states I must say that those two recommendations won't do anything to prove actual residency in any one particular state.
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Offline Ann

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Re: Living overseas, uninsured.. Treatment options?
« Reply #31 on: March 08, 2010, 10:42:35 AM »

Granted, they are in India and probably don't give a rat's patoot what U.S. law says, but in my eyes, they are still doing a dishonest thing.


How is it dishonest when 1) Cipla doesn't make a profit on ARVs and 2) they're enabling millions around the world to have access to life-saving drugs they otherwise could never afford.

I think Big Pharma is being far more dishonest by making the huge profits they do from ARVs. They amounts they charge are far and away above what they cost to produce, R&D included.
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Offline RapidRod

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Re: Living overseas, uninsured.. Treatment options?
« Reply #32 on: March 08, 2010, 10:49:55 AM »
How is it dishonest when 1) Cipla doesn't make a profit on ARVs and 2) they're enabling millions around the world to have access to life-saving drugs they otherwise could never afford.

I think Big Pharma is being far more dishonest by making the huge profits they do from ARVs. They amounts they charge are far and away above what they cost to produce, R&D included.
It's called patent theft and fraud. Take a look at the legal background on Cipla. They have a history of patent theft and it doesn't only involve ARVs.

Offline joemutt

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Re: Living overseas, uninsured.. Treatment options?
« Reply #33 on: March 08, 2010, 10:57:51 AM »
Cipla does it not for profit but to save millions of lives.
As did GPO in Thailand.

Offline Hellraiser

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Re: Living overseas, uninsured.. Treatment options?
« Reply #34 on: March 08, 2010, 11:03:04 AM »
If you want to make money Medicine should not be your business.  With that said, without profit motivation a lot of the medicine that we have today might not exist.  It's a catch-22.

I think the only real way around it is to profit cap corporations to make the money they spent on research back and then an amount past that.  The reason drugs that work cost so much is they sunk a lot of money into drugs that don't work, so they're trying to recoup their costs.  Unfortunately those of us in the US have to pay the price for most of the rest of the world.  Those of us who are uninsured in the US have it the worst, although we do have ADAP to help.  It's a sticky situation all around and not really the point of this thread.  If I were him, I would beg barter and steal my way to insure the steady supply of my HAART.

Offline RapidRod

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Re: Living overseas, uninsured.. Treatment options?
« Reply #35 on: March 08, 2010, 11:07:15 AM »
Cipla does it not for profit but to save millions of lives.
As did GPO in Thailand.
Then why would any Phara company want to do any R&D on any drug just to have their patents stolen? Why would they want to continue research if all they would need to do is wait and steal a patent?

Offline Inchlingblue

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Re: Living overseas, uninsured.. Treatment options?
« Reply #36 on: March 08, 2010, 11:15:35 AM »
The reason drugs that work cost so much is they sunk a lot of money into drugs that don't work, so they're trying to recoup their costs.  


That's not the only reason drugs cost so much. Malcolm Gladwell wrote an amazing piece in The New Yorker, in which he exposed a lot of the tricks up the drug companies' sleeves.

LINK:

http://forums.poz.com/index.php?topic=26145.msg331462#msg331462
« Last Edit: March 08, 2010, 12:52:54 PM by Inchlingblue »

Offline Ann

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Re: Living overseas, uninsured.. Treatment options?
« Reply #37 on: March 08, 2010, 12:39:19 PM »
I don't have anything against pharmaceutical companies making a profit, I object to them making an obscene profit. And they do. If they weren't so damned greedy, maybe companies like Cipla wouldn't have to "steal" patented medicines in order for people to survive.


That's not the only reason drugs cost so much. Malcolm Gladwell wrote an amazing piece in The New Yorker, in which he exposed a lot of the tricks up the drug companies' sleeves.


That's another thing that really gets me - the obscene amounts they spend on marketing. Medicines that must be prescribed by a doctor should never be advertised to the general public. Thank goodness they have a ban on such practices in the UK.
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline azprince

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Re: Living overseas, uninsured.. Treatment options?
« Reply #38 on: March 08, 2010, 08:15:00 PM »
I don't have anything against pharmaceutical companies making a profit, I object to them making an obscene profit. And they do. If they weren't so damned greedy, maybe companies like Cipla wouldn't have to "steal" patented medicines in order for people to survive.

That's another thing that really gets me - the obscene amounts they spend on marketing. Medicines that must be prescribed by a doctor should never be advertised to the general public. Thank goodness they have a ban on such practices in the UK.
:-* :-* :-*

I totally agree with what you said; btw I rarely do that, so you are privileged  ;D
I have to admit : the good thing is that from now on;  I have no option but to succeed , still its ok to worry :))

Offline mecch

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Re: Living overseas, uninsured.. Treatment options?
« Reply #39 on: March 08, 2010, 08:45:31 PM »
  Unfortunately those of us in the US have to pay the price for most of the rest of the world.  Those of us who are uninsured in the US have it the worst, although we do have ADAP to help.  It's a sticky situation all around and not really the point of this thread. 

Many countries pay top dollar, not just the USA. But yes for the second point, because Europe and selected other countries have figured out a way to pay for patented drugs and still have near universal health care.  Shame on the Americans (me included) who still insist its the best and richest country in the world. Not so.
ďFrom each, according to his ability; to each, according to his needĒ 1875 K Marx

Offline Ann

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Re: Living overseas, uninsured.. Treatment options?
« Reply #40 on: March 08, 2010, 09:04:46 PM »
:-* :-* :-*

I totally agree with what you said; btw I rarely do that, so you are privileged  ;D


~genuflect~
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline sanitex

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Re: Living overseas, uninsured.. Treatment options?
« Reply #41 on: March 08, 2010, 11:32:49 PM »



h! lordbenner,try to pm me lets discuss what to do and how you would get your meds without
useing your personal money .
27/12/07 cd4 20 vl 1million
10/4 /08 cd4 86 vl 63
1/7/08  cd4 186 vl undetectable
16/10/08 cd4 196 vl undet
23/1/09 cd4 248 vl un
10/9/11 cd4 418 vl <40 %22
13/12/11 cd4 410 vl undet 23%
24/2/12 cd4 545 vl undet 26%
on 22/2/12 change truvada to Recovir-EM
due to no stock on Truvada.
10/9/11 cd4 418 vl <40 %22
7/7/12 cd4 359 vl <40 22%
23/8/12 cd4 400 vl <40 23%,
testosterone test 7.5 ng/ml and
thyroid (TSH)1.32 ulu/ml creatinine.eGFR blck 1.5 all fasting test morning.
13/12/2012 cd4 523 24% vl <40
18/3/2013 cd4  513  23% vl <40
regimen ATRIPLA
03/8/2013 cd4 429 22% vl <40
13/11/2013 cd4 455 23% vl <40
Anti-HBs test (quantitative ) Anti-HBs positive
Titer 16.95 mlu/ml <10.00
22/3/14 cd4 396 vl <40 % 24

Offline LordBerners

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Re: Living overseas, uninsured.. Treatment options?
« Reply #42 on: March 09, 2010, 02:17:07 AM »
To clarify:

You've been infected with HIV for 2.5 years and you don't even know if that's legal or not?

I wasn't referring to whether or not it was illegal to have hiv or for a foreigner to be in Thailand with hiv - both are legal.  What I was referring to was whether one may work in Thailand with an expensive and potentially debilitating disease.  Like most countries, Thailand's rules for work permits are far more restrictive than rules for merely visiting.

hiv is not on the list of diseases that Thai immigration would stop you for :
1. Leprocy
2. Tuberculosis
3. Elephantiasis
4. Drug addiction
5. Third step of Syphilis

Like I said above, I'm concerned about eligibility to work - to get a work permit - not about merely being allowed to be here.  I mean if you think about it why would Thailand allow foreigners to come here and work only to cost their social security thousands of dollars a year.. they're a nice and welcoming country, but I'm afraid anti-guest worker rhetoric plays well even here in a kinder culture.

Regarding the discussion of the privileges of patent holders and corporations above, I'll only say I'm forever astonished to find the right-wing position so strongly supported here!
Please, just call me Berners.. or Baron.

Offline joemutt

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Re: Living overseas, uninsured.. Treatment options?
« Reply #43 on: March 09, 2010, 04:26:16 AM »
I worked here 15 years of which 12 poz without a problem.
The medical certificate for my work permit that states that I'm in good health,
I get from a Clinic for 80 thb. I think once you pay your taxes here you're absolutely entitled to
enjoy the benefits. Hope you find your way out.

Offline David_CA

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Re: Living overseas, uninsured.. Treatment options?
« Reply #44 on: March 09, 2010, 07:54:09 AM »

Regarding the discussion of the privileges of patent holders and corporations above, I'll only say I'm forever astonished to find the right-wing position so strongly supported here!

That's BS.  I don't think that because people point out that some countries don't play by the same patent rules (but get the benefits) is considered right-wing.  Having a non-US resident ask how to get ADAP meds without expecting those who are residents, who live with the concerns of not having funding for their meds get a bit irritated is unreasonable. 

I'll go out on a limb and say this: a 'real' teacher in the US would have insurance that covers HIV meds.  I'm not insinuating that your not a real teacher, but I say that because I'm referring to those who teach in public and regular private schools.  I wonder if it's different here for non-citizens, though.
Black Friday 03-03-2006
03-23-06 CD4 359 @27.4% VL 75,938
06-01-06 CD4 462 @24.3% VL > 100,000
08-15-06 CD4 388 @22.8% VL >  "
10-21-06 CD4 285 @21.9% VL >  "
  Atripla started 12-01-2006
01-08-07 CD4 429 @26.8% VL 1872!
05-08-07 CD4 478 @28.1% VL 740
08-03-07 CD4 509 @31.8% VL 370
11-06-07 CD4 570 @30.0% VL 140
02-21-08 CD4 648 @32.4% VL 600
05-19-08 CD4 695 @33.1% VL < 48 undetectable!
08-21-08 CD4 725 @34.5%
11-11-08 CD4 672 @39.5%
02-11-09 CD4 773 @36.8%
05-11-09 CD4 615 @36.2%
08-19-09 CD4 770 @38.5%
11-19-09 CD4 944 @33.7%
02-17-10 CD4 678 @39.9%  
06-03-10 CD4 768 @34.9%
09-21-10 CD4 685 @40.3%
01-10-11 CD4 908 @36.3%
05-23-11 CD4 846 @36.8% VL 80
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Offline Inchlingblue

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Re: Living overseas, uninsured.. Treatment options?
« Reply #45 on: March 09, 2010, 01:02:12 PM »
I know what they are doing, and it may well be legal in India. But CIPLA did not develop the drugs used in their generic Atripla, they incurred no cost from its initial testing or clinical trials, and they are flouting U.S. law.


You can agree or disagree with Indian patent laws but Cipla is a legitimate enterprise and operating legally. They are not importing these HIV drugs into the US and are therefore not breaking any US laws.

The FDA recognizes Cipla as a legitimate drug manufacturer and has approved several of their generics into the US market.

International patent treaties and agreements are a whole 'nuther kettle of fish, which can get very complicated and political but Cipla is not doing anything wrong or illegal.

Additionally, the board of UNITAID recently voted to launch a patent pool, in which patent holders agree to allow generic versions of HIV and TB drugs in exchange for small royalty payments. I'm not sure if Cipla's HIV generics are part of this (or will become part of it) but there's no reason to assume that just because an HIV drug is under patent in the US and available generically in the developing world that this is "flouting the law."

LINK:

http://www.cfr.org/publication/21184/timely_rx.html

http://www.guardian.co.uk/world/2009/dec/15/unitaid-aids-drug-patent-pool

http://www.aidsmeds.com/articles/unitaid_patent_pool_1667_17727.shtml
« Last Edit: March 09, 2010, 01:41:29 PM by Inchlingblue »

Offline leatherman

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Re: Living overseas, uninsured.. Treatment options?
« Reply #46 on: March 09, 2010, 08:33:37 PM »
They are not importing these HIV drugs into the US and are therefore not breaking any US laws.
they are too breaking US law - US patent laws. ::)

Stealing someone's product, producing it yourself, and selling it in another country doesn't make the theft legal.
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Oh my friends, my friends forgive me
That I live and you are gone.
There's a grief that can't be spoken.
There's a pain goes on and on.
Empty chairs at empty tables
Where my friends will meet no more.

"Empty Chairs at Empty Tables" from Les Miserables

Offline Hellraiser

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Re: Living overseas, uninsured.. Treatment options?
« Reply #47 on: March 09, 2010, 08:56:32 PM »
they are too breaking US law - US patent laws. ::)

Stealing someone's product, producing it yourself, and selling it in another country doesn't make the theft legal.

It's only illegal in the US.  They're in India.

Offline RapidRod

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Re: Living overseas, uninsured.. Treatment options?
« Reply #48 on: March 09, 2010, 09:00:39 PM »
It's only illegal in the US.  They're in India.
So if someone from India electronically drains your bank account then that makes it ok?

Offline Hellraiser

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Re: Living overseas, uninsured.. Treatment options?
« Reply #49 on: March 09, 2010, 09:07:08 PM »
No, but when it comes to lifesaving medicine the cost should be what it takes to manufacture and ship the drug to you, not to be gouged for as much as you're able to pay.  I've already stated earlier in this thread how I feel about all this I was just pointing out that while it may be against US law, this company isn't operating in the US and it also isn't even putting a dent in Gilead's profits.
« Last Edit: March 09, 2010, 09:09:04 PM by Hellraiser »

 


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