Atripla costs Holy *@^%+!@#$!!!!!

[pozmnguy]

I wanted to say thanks to all who post here.  This venue is really pretty cool and seems to help many. Okay I was wondering if as a bunch of old pro's I could run this one past you.  As only being diagnosed a few months ago and immediately placed on Atripla (which is working awesome and seriously kicking some butt), does anyone know if it can be purchased for a better price in other countries.  I am very lucky to have a good job and the frequent flyer miles with the credit card are great but I would rather have a new Lexus!   

[mecch]

You are opening up a can of worms with that question.  I hope you have a good specialist who can frankly discuss all the issues (and possible dangers) involved in buying treatment overseas.

There is "real" and off-license HAART manufactured around the world. Here is a link to get you started thinking about it, at least politically:

http://www.bio-medicine.org/medicine-news/Merck-Announces-Plans-for-Licensing-Atripla-Widely-in-Developing-World-18495-1/

Also, look for "FAIR PRICING COALITION" on this site, and with GOOGLE.

In summary, this info, from one year ago on AIDSMAP:
"Tenofovir is currently unaffordable for most countries, but that is set to change, according to Anil Soni of the Clinton HIV/AIDS Initiative, which has been working with generic manufacturers to bring down tenofovir costs in the past year. He said that four manufacturers will have submitted dossiers for WHO prequalification of generic versions of Atripla (tenofovir, 3TC and efavirenz) by the end of the year, and eight manufacturers will have submitted generic tenofovir tablets by the end of the year."
http://www.aidsmap.com/cms1236753.asp

I hope some expert steps in here to advise you.

Do not mail order HAART from another culture.  An Indian or Tanzanian might be garanteed through their national/local health care channels of professionals to get great and cheap "atripla like" treatment. Doesn't mean you would get the same if you went shopping.

[sharkdiver]

I hope with your good job you have good insurance.

[pozmnguy]

Thanks mecch I will investigate. All kinds of my Friends keep saying can't people buy it cheaper in Canada.  Heck its only a 3 hour drive.

[mecch]

I was just saying be careful if you go out of your own culture - for instance to Tanzania.  The price difference could be radical!
USA to Canada or Mexico, why not.
Not my forte - ask professionals.
good luck!

[BT65]

I personally have never bought meds out of the states.  I'm wondering if you have insurance with your employer?

[G-Love]

I think, that whatever you decide to do, make sure that you have your doctor involved. Atripla is not even available in Canada yet.

[pozmnguy]

Well the actual prescription without insurance would be $1,708.00 per month.  I pay $708.00 of that because the max per prescription is $1,000 per month on my present plan.  I will be able to change my coverage in Feb to 100% covered but thought I would check it out.  I don't like when these suckers mess with my mad money.  The last time I was at the Doctor I did tell him the reason people are dying are these outrageous drug costs.  It does explain my cousin who is a drug rep getting a $150k Christmas Bonus however.   Thanks G-love for the Atripla Canada info my mother keeps offering to go up there and pick the prescription up.  I will tell to go get a massage instead

Good news for some people is that Bristol Meyer Squibb does offer assistance to people with getting meds if they meet the income guidlines.

[mecch]

Ask your doctor and ask your insurance if they will cover TRUVADA and SUSTIVA -- two prescriptions. If they pay 1,000 per DRUG, then Atripla is not your best buy considering your insurance plan.  If it is 1,000 per month then you are screwed. But truvada and sustiva should each be below 1,000 a month, and thats the same treatment as Atripla.

[prayerblue]

sorry to ask, but in general what are income guidelines for pharmaceutical companies help with meds in lieu of insurance? and is it hard to qualify for the ryan white title act assistance?

[mecch]

Cant help you.

This is an aside but if you are American and what's more, gainfully employed, what's wrong with the USA that makes getting effective treatment such a hassle?

I feel for you, man.

Everyone riot, and vote Democrat, and do whatever it takes so that the USA, a first world country, has first world health care for all!

(Geez, now you are handing out billions and billions for rich bankers -- and nothing for the working stiff?!!  Oh yeah, and treat the unemployed as well!)

"It is all very well to talk about how everybody has a universal right to medicine but if you do not have it, a right is not really a right," Mr. Clinton said.  "An unexercised right does not really exist."  http://www.voanews.com/english/archive/2008-08/2008-08-04-voa33.cfm?CFID=43690753&CFTOKEN=73933480

[Ann]

It does explain my cousin who is a drug rep getting a $150k Christmas Bonus however.  

  Really? $150K? K? Not One hundred and fifty dollars, but one hundred and fifty THOUSAND dollars?

~bangs head on desk~

~repeatedly~

[mecch]

Is what you refer to an annual bonus, based on his overtarget sales, and company profits, paid at XMAS time, and not a "christmas bonus".  I assume its annual.

I got my first "13th salary" last year, and also a "vacation bonus" -- the latter kind of under the table.  A great European moment for me.  Joy (cause I got it) and rage (most Americans work too hard for too little return).  As an expat, the routine 13th Salary was this eldorado and I was dumpfounded looking at my monthly pay statement!

Its like those moments in Michael Moore's SICKO already mentioned. The Parisian middle class couple gets this state-paid helper come in to do the laundry and dishes cause Madame just had a baby....  Americans have mixed feelings seeing that stuff - cognitive dissonance which is Moore's particular brillance.

I LOVE AMERICA but jesus it has big challenges and one surely is income distribution and quality of life for everyone -- not just the RICH.

Soon after Bush got elected he was touring Europe and the USA kept sending the message to European socialist governments headed by more "free-market presidents" that they couldn't POSSIBLY continue socialist welfare states - that gonzo capitalism was the ONLY solution for Europe.  Hell Clinton did pretty much the same protheletising. Some politicians took all that American Dillinger Capitalism seriously.

Happliy most of Europe is slow moving and social welfare so entreched, cause now we see through what that kind of capitalism really represents -- China poisons its own babies in their embrace of greed, and the USA... well the guy who started this thread can't rest peaceful about his medical costs!! 

Can we assume that for many American pozzies, the price of Atripla does indeed boggle the mind. And that for many French pozzies, its simply the price of fresh fish that astounds. 

As Moore says, what's wrong with this picture? 

And no American congress, in the next few weeks, is going to ask all those investment bankers to give back 10 years of extreme bonuses to put into the kitty to "rescue" the financial markets.   

[Ann]

It does explain my cousin who is a drug rep getting a $150k Christmas Bonus however.  

I still can't get my head around this. A $150K BONUS? That's totally mind-boggling. That's more than most make in a year - or several years. No wonder meds cost so much money. Research and development my arse! The real costs are in the flogging.

pozmnguy, maybe your cousin could help you with your meds costs. Just sayin!

[LordBerners]

I still can't get my head around this. A $150K BONUS? That's totally mind-boggling. That's more than most make in a year - or several years. No wonder meds cost so much money. Research and development my arse! The real costs are in the flogging.

I couldn't agree more with your outrage, Ann, though the $150K bonus doesn't surprise me at all.  But keep in mind the real money is being made by the owners/high level executives of the drugs companies, not some salesman.  To them $150K is like a dollar would be to you or I - nothing.  These people spend that to re-do their bathroom.  As we all know, this is america.

But regarding the original poster's question - here in Thailand I believe Sustiva/Truvada is just a couple hundred dollars a month, possibly less (for the moment - every day the US govt places great pressure on the Thai gov't to cease 'breaking the patents'). 

The problem would be getting your doctor in Thailand supply you with enough to make it worthwhile - if you have to fly back and forth every 3 months at $1,400 round trip it isn't much of a savings.  I don't know what are the requirements of supervision of treatment but I'm sure your doc would let you know how often you would need to be evaluated (in my experience it has been at least every three months but that's just my experience).  Lastly you may have a big problem getting your purchase from the free country back into the Police State - american customs are a nightmare.

[mecch]

Thailand pays Merck .65 cents per pill, according to one source. 
http://www.pharmaceutical-business-review.com/article_feature.asp?guid=8A869BFC-88A5-4131-8CA3-231EE6F6E46C

(I have a 10% copay and that adds up to much higher than the full price of the treatment in some countries. But then I have great doctors, hospitals and a European salary!)

Someone must be able to refer the original poster to a contemporary 2008! source or person who knows about overseas buying.  (R.I.P. Stephen Gendin.)

He could also contact an HIV drug supplement buyer's club in a major US city who might refer him to correct and contemporary sources about buying HAART overseas.  Or his local HIV/AIDS service organisation.
http://www.newyorkbuyersclub.org/index.html

Its a fascinating topic, this, pricing + access.

I dont think the POZ community can dump universally on all the pharm industry all the time. In very recent years, this has all gotten MUCH more complicated and there are a lot of grey areas (and grey products) where governments, PLUS middle men and brokers such as Clinton and even Bush, PLUS pharm corps are doing good work to increase access and decrease costs and guarantee the pipeline for ever improving treatment.

Isn't it appropriate to shift blame sometimes to those governments that DO NOT get their health ministries and priorities functioning to guarantee treatment access to all poz people who need it - by rolling up their sleaves and working with said middlemen and said pharm corps??  Thailand and Brazil, from what I understand, do pretty well in this process.  Who wouldve ever thought that Jesse Helms + Bono + Bush could do good work but they did.  (Well sorta, cause dumping second rate outdated HAART in the developing world is a mixed "success"). 

So the future is filled with possibilities for improved access when people have the courage to change their minds, be diplomatic, and give and take.

[vivyt]

I am VERY fortunate in that I have great insurance and I only pay $20 for my Atripla prescription. It is higher than the other ones though. Usually I receive generic for $10. I don't know what I would do if I was in a different situation but I do know that something needs to change.

[pozmnguy]

LOL yes $150,000 dollars annual bonus that they happen to receive at Christmas based on performance.  Funny it does not suprise me though having other friends that are in Pharmaceutical sales with similar bonuses.  I just picked my prescription $708.00 later and my pharmacist says that Atripla is actually made up of 3 drugs and would be more expensive if ordered separately.  I will find out exactly how much next week when I have my quarterly Dr. visit.

Thanks again everyone.

[Iggy]

 

Well the actual prescription without insurance would be $1,708.00 per month.  I pay $708.00 of that because the max per prescription is $1,000 per month on my present plan.  I will be able to change my coverage in Feb to 100% covered but thought I would check it out.  I don't like when these suckers mess with my mad money.  The last time I was at the Doctor I did tell him the reason people are dying are these outrageous drug costs.  It does explain my cousin who is a drug rep getting a $150k Christmas Bonus however.

I'm glad that you are going to be able to get the full coverage in February as the $708/month is just criminal (particularly in the context of your bro-in-law's bonus as a pharma rep)

Even with great insurance these days as Jeromy and I have, it is just hard to get by because we need to actually use it vs. just have it for an "in case we get sick we're covered" type thing which I believe is how it is viewed by many people in the U.S. (particularly when they have intellectual debates about universal health care)

Jeromy and my combined doctor's appointments plus all of our meds averages n the $200-$300/month range and that is with great insurance.  This doesn't count the dental visit (we postponed for over a year  until recently) and things you just can't schedule such as an extra visits to the doc due to something like the flu or an emergency situation.

It's one of the reasons I entered the clinical trial that I am now in as the idea of adding an additional $50-$75 a month in prescription costs to our monthly budget was unfathomable.

[BT65]

picked my prescription $708.00 later and my pharmacist says that Atripla is actually made up of 3 drugs and would be more expensive if ordered separately. 

Yes, that was a foolish suggestion to buy them separately. 

[hotpuppy]

Yes this is a can of worms, and they all have sharp teeth.

Going back to prayerblue's question:

In Texas, if you make less than 32K/yr (it varies) you can get help with your meds to make them nearly free.  $32K-$50K you pay some.  Over $50K and I hope you have a good job or no liabilities.

You can also join the THHIP  Texas High-Risk Health Insurance Pool which is approximately 30% more than the highest rate charged.  Which for me as a 36yo non-smoking male is about $400/mo.  There is a 12 month pre-existing condition clause, but than it covers your meds and is decent insurance.  It's not a handout like some of the big company stuff, but it beats a $1700 prescription.

Your other option is to participate in a drug study.  I chose this route and my meds are free.  As a bonus I'm on something you can't buy yet.  The risk is I'm a guinea pig and if something stops working I could find myself needing to be on other meds. 

Life is good isn't it?  lol, you can get coverage, it just takes some work.  Being HIV+ means your medical care is very important to your survival.

[Desertguy]

                                                                 "WOW"

Guess I am the lucky one here!!!

My co pay is $8.00!!!    But go thu the VA

[Mike89406]

Yeah I'm glad I don't pay for the Atripla either. I picked up my last prescription from Longs Drungs and the listed price on the prescription was over $4800 for 90 tablets which is my standard prescription.

Mike

[mecch]

Yes, that was a foolish suggestion to buy them separately. 

Not foolish. I asked him if he gets 1,000 per PRESCRIPTION/drug or 1,000 per month.  I would assume it is 1,000 per drug!  Therefore, since SUSTIVA and TRUVADA are the same as ATRIPLA -- just 2 pills at night instead of one - and if SUSTIVA costs (for example) 800 and TRUVADA 800, they would both be completely covered since each prescription is less than 1,000.  (The third drug is in the TRUVADA.)

This is a technique used in my country to get full coverage until ATRIPLA is approved - since it is so expensive it currently exceeds "justified" cost.

Just saying...

But poster did not respond as to details of his coverage.  As is his privilege.

[BT65]

Mecch, he just said he talked with the pharmacist who informed him it would be more expensive should he buy them separately.

[blondbeauty]

A bit expensive there. Here 775 euros and free of charge thanks to NHS.

[mecch]

No need for a catfight. I read what he said. Did you read my explanation?
Yes the total amount is higher purchased separately. The retail price.
Maybe not the out of pocket expense to the insured purchaser.

Insurance companies are strange and run on routine. Two bottles of pills, on two prescriptions, cost slightly more than Atripla (1 drug, 1 presscription), but the patient pays less because each prescription is covered, fully. 

This happened to my dad when he had cancer. 

[gaz41]

The retail price of Truvada in Germany is 742 Euro , i pay a prescription charge of 10 Euro, but the receipt always shows th retail price as well

742 € must be about 1000 usd at current exchange rates

[Oceanbeach]

sorry to ask, but in general what are income guidelines for pharmaceutical companies help with meds in lieu of insurance? and is it hard to qualify for the ryan white title act assistance?

I am disabled with a Social Security income of less than $1,000.00 per month.  I do not qualify for RWCA assistance and have not ever qualified for RWCA funding because I have Medicare/Medi-Cal (Medicaid) and ADAP assistance on my Part D expenses.  Today, I received my statement from WellCare re: Year to date expenses for Medicare Prescription Coverage (Part D).  I take 2 Trizivir each day and 12 Sustiva each day.
My total drug costs, this year, to date is: $13,914.77
Out of pocket costs, paid by ADAP is: $4,455.33.

RWCA Title I funding support is not offered in every county, 6 of 52 counties in California receive Title I funding.  It is the payer of last resort and is used only for those who have no other way to pay for medical services.    Have the best day
Michael 

[hivsweden]

$1750? I thought Sweden was expensive @ USD 1266 which is 100-200 USD higher than many other European countries. Thankfully we don't have to pay anything for hiv care or meds so the bill is 0.00. The only meds I pay for are my SSRI and loperamide and even then I don't pay full price.

Up to USD 133/yr we have to pay 100%
USD 133-250 we pay 50%
USD 251-487 we pay 25%
USD 488-634 we pay 10%

With these discounts the maximum amount we have to pay each year is USD 266. For non-Hiv heath care the maximum cost is USD 133/yr.

[Miss Philicia]

I pay nothing for anything -- and I've even been going to the dentist once a month for the past 5 months for a complete reconstruction of the bottom of all of my teeth with porcelain veneers, all courtesy of Ryan White and the University of Pennsylvania dental college.

And my dentist is a drop dead gorgeous man with a goatee from Baghdad.

Oh, I do pay for generic klonopin -- sadly they don't believe in covering anxiety medications here.   And I had to pay a token $5.61 for Chantix, but ADAP paid most of it which would have been something like $150

[GSOgymrat]

And my dentist is a drop dead gorgeous man with a goatee from Baghdad.

He imported his goatee from Baghdad?

[Miss Philicia]

He imported his goatee from Baghdad?

Actually it was more like heavy, swarthy 12 o'clock shadow.  I'm far from a top, but all I could think of was face fucking him for several hours.

That said, he's an excellent dentist and quite friendly, though unfortunately straight and married.  Oh well, there's always my new hairy "bear" psychologist to look forward to, but he's nothing as stellar as Dr. Petros.  He could totally model.

I've had a decent run of physically acceptable medical professionals -- my HIV specialist isn't hard on the eyes either, and he's from Lebanon.  It's like my entire well being is courtesy of al Qaeda.  (OK... that was a bad joke).  But it's a huge change from the gay mafia of overweight Jewish doctors I had in NYC, delightful as they all were (especially the one that always wore Tweety Bird socks).

[GSOgymrat]

I'm jealous. Although pleasant and competent, none of my providers are anything to look at. I used to have a Korean dentist who was and gay and into leather. He was very chatty and used to keep me entertained with stories of his latest tattoo or circuit party as he worked on my teeth. He gave me a reduced rate because at the time I was uninsured and HIV+. He was probably the best dentist I've ever had.

[rick21007]

pozmnguy--you might want to shop around for Atripla prices from several pharmacies.  Pharmacies do not always charge the same retail prices.  My pharmacy prices Atripla at $1500 mo. (my insurance covers all but a $35 co-pay plus a $200 deductible I had to fork over in July for the year.)

Rick

[madbrain]

Yes, that was a foolish suggestion to buy them separately. 

The total cost would be more expensive if ordered separately for sure. The question is who would pay for that cost ?

If his insurance plan is really $1000 per drug per month, and not $1000 per month total, then having two prescriptions will cost the original poster less - and cost his insurance company more.

If his maximum really is $1000 per month for all drugs, then he might want to start looking at ADAP. In many states you can have both ADAP and insurance if you meet the income guidelines. ADAP will pay whatever your insurance doesn't pay. So they would pick up the $708.

My bf has 4 prescriptions right now, 3 of them brand names for HIV. The monthly copay for each of those is $30. Then the 4th is a generic with a $10 copay. It is not an HIV med, but it is on the ADAP formulary. His total copays for meds would be $100 for those 4 meds. He still can't afford it. But he has ADAP, and they pay the full $100 copay every month. Kaiser pays the other $2165.

[madbrain]

I just noticed that Costco started carrying Atripla. Their retail price for 30 is $1429.09.
If they accept your insurance, then your share of cost would go down to $429 per month.

But I would look into the alternatives first - either having 2 separate prescriptions for Sustiva and Truvada, or combining your insurance with ADAP if you qualify.

[mecch]

Thank you mad brain for explaining again what I tried to explain. I dont think it was a foolish suggestion.
I believe we have lost the interest of the original poster, however.

Best to all

[pozmnguy]

Thanks so much,  I just got off the phone with my Nurse and she has been tracking plenty of stuff down for me.  My actual insurance covers a percentage which varies from prescription to prescription.  That evidently is why it would not be any better to get it filled as three separate drugs.  I do like the Costco Idea.  Heck saving $300.00 dollars a month is still $300.00 per month.

You guys are the best.

[madbrain]

Hey,

My actual insurance covers a percentage which varies from prescription to prescription.

OK. A percentage differs quite a bit from what you wrote earlier about $1000/month per drug. It would help for you to review the details of your insurance's prescription coverage more carefully to see just what kind of coverage you have. If you don't have them in writing you should be able to call the insurance company and inquire about it.

That evidently is why it would not be any better to get it filled as three separate drugs.  I do like the Costco Idea.  Heck saving $300.00 dollars a month is still $300.00 per month.

You guys are the best.

Glad to be able to help ! Costco does have a $50 annual membership fee. But that should be easily offset by the cost savings. But again you need to check if they will take your insurance, which is not a given. See Costco pharmacy FAQ at http://www.costco.com/Browse/Productgroup.aspx?Prodid=11296409 , in particular 12 and 13.

Even if Costco pharmacy won't take your plan, you may still be able to realize the savings by paying the entire cost upfront, and then getting reimbursed by your insurance by submitting a claim. But once again you have to talk to your insurance company to see how they work.

[sharkdiver]

Atripla is pretty cheap, relatively speaking. Hopefully you will be able to stay on it for awhile.  My Reyataz, Norvir, Truvada runs about $7,000.00 if I had to pay fulll retail price.

[hivsweden]

Sharkdiver - A comparison with Sweden.

Truvada 30pcs SEK 5830
Reyataz 30pcs/300mg SEK 4436 (60x150mg is same price)
Norvir 30pcs SEK 380 (Price calculated from bottle with 84pcs)

Sum: SEK 10646 / month = approx. USD 1520 retail price.  Is your $7000 a per year price?

[sharkdiver]

per month

[madbrain]

sharkdiver,

Atripla is pretty cheap, relatively speaking. Hopefully you will be able to stay on it for awhile.  My Reyataz, Norvir, Truvada runs about $7,000.00 if I had to pay fulll retail price.

$7000 per month ?

That's the same regimen my partner is on (+ celexa) and his last monthly receipt from Kaiser for the 4 meds says that his insurance saved him $2225 (2125 from his policy, 100 from ADAP) - with his share of the cost $0 . You must be on higher dosages than he is. He takes only one of each at night.

Truvada cost is $930 at Costco for 30 . http://www.costco.com/Pharmacy/frameset.asp?trg=HCFrame.asp&hcban=Banner.asp&hctar=DrugInfo.asp&log=&rxbox=&fromscript=1&qf=&srch=truvada&Drug=TRUVADA&Article=TRUVADA .

Reyataz is $466.76 for 30 ($953 for 60) .
http://www.costco.com/Pharmacy/frameset.asp?trg=HCFrame.asp&hcban=Banner.asp&hctar=DrugInfo.asp&log=&rxbox=&fromscript=1&qf=&srch=reyataz&Drug=REYATAZ&Article=REYATAZ

Costco does not carry Norvir, or at least do not show the price for it online.
But RXUSA has it for $277.74 for 30 at http://rxusa.com/cgi-bin2/db/db.cgi?ndc=00074663330

So that adds up to $1675 for the retail price of this regimen.

[adamsmith]

Atripla is incredibly expensive, im sorry you are having this trouble.







Edit, sorry I removed the links to generics I didn't know and the posts above were asking for overseas sources.

[anniebc]

Adam

Please edit your post..we do not endorse buying drugs on line...if you do not then I will discuss with the Mods and Admin about removing your post...thank you for your cooperation.

Messages posted to the AIDSmeds.com Forums must not contain marketing information, either from a pharmaceutical company; a healthcare provider (i.e., seeking to provide services to the HIV community); or the manufacturer or distributor of a complementary, alternative, herbal, traditional, and/or surgical treatment approach.

Jan

[stratosphere]

I consider myself lucky after reading throug all of this.  I have BCBS Govt plan and i get Sustiva & Truvada through mail order (Medco) and a 90 day supply of each costs me only $70.00 for both! 

Best of luck 

[AndyArrow]

I have to pay $942.00 per month in medical expenses and then Indiana Medicaid will pay all other medical expense.

Moral of the story:   DON'T MOVE TO INDIANA   

8 months to go b4 medicare kicks in ... hopefully I can pay the bills somehow until then.   Did I mention Indiana Sucks? 

 AA

[pozmnguy]

Hey All,

I Figured I would give you a little update.  I had my quarterly appt w/ my Doc yesterday.  I talked to him about leaving Atripla to explore taking the 3 drugs individually.  He asked that we stay the course for now simply because I am responding so well to it.  I had to agree cuz "I'm worth it"!  Isn't that from a Clairol commercial?  Anyway, I am going to further explore the Costco or Sam's Club Pharmacy options.

You guys are the greatest.

Jim

[madbrain]

Jim,

Hey All,

I Figured I would give you a little update.  I had my quarterly appt w/ my Doc yesterday.  I talked to him about leaving Atripla to explore taking the 3 drugs individually.  He asked that we stay the course for now simply because I am responding so well to it.  I had to agree cuz "I'm worth it"!  Isn't that from a Clairol commercial?  Anyway, I am going to further explore the Costco or Sam's Club Pharmacy options.

You guys are the greatest.

Jim

Taking Atripla or the 3 drugs separately should be exactly the same from a medical point of view. Didn't your doc tell you that ?

Did you talk to your insurance company yet about your coverage ?