Medication assistance

MEDICATION ASSISTANCE

FOR

SEXUAL ASSAULT VICTIMS

Prepared by Lynn Young LSW, Social Worker, IU Health Methodist Hospital

MEDICATION: TRUVADA
PHARMACEUTICAL COMPANY: GILEAD
ICD-9 CODE: 995.8
For patients with no insurance to cover the follow up medication for 28 days, you can apply for patient
assistance from Gilead for Truvada by phone. You can contact them at 800-226-2056. Be sure to have a
release of information signed by patient prior to calling Gilead.
You will need to have the following information available when you call. Patients, name, address, date of
birth, phone #, as well as ICD Code (listed above). They will want to know patients monthly household
income (must include income of spouse and/ or dependants) and household size (all those financially
responsible for pts / spouses income as they would claim on taxes). If patient has no income, they will ask
how they are supporting themselves to which I generally respond, “family and friends”, which has always
been acceptable.
Gilead will also need a letter from NP or MD indicating the date patient was assaulted, date patient was seen,
date patient was started on Truvada (if meds have already been started), and plan for continued days of
Truvada needed to complete the course of therapy. This should also include any other meds patient is on.
(see sample letter we use). This letter will need to be faxed to: 800-216-6857. I fax this letter to them prior to
my calling so they are ready with it when I call.
If approved (as is income based), Gilead will provide you with an approval billing ID#, Bin #, and Group #
which you can give to patient to take with the prescription to their pharmacy. Not all pharmacies keep
Truvada in stock and not all are aware of how to bill Gilead. I would recommend you explore ahead of time
pharmacies in your area that you can refer pts to. Most hospital OP retail pharmacies are familiar with this
process.
Obtaining this free 28 day supply by phone can only be done once per patient. (Patients who present for
treatment following assaults on multiple occasions may be denied the free by phone approval if has receive
asst in the past, and will need to apply via formal application, and providing proof of income. These
applications are available from the company at 800-216-6857 or at rxassist.org which is a website that has
info and applications available for patient assistance and discount programs for a wide range of
medications.)
Gilead also has a co pay assistance program for those with insurance. You can access the co pay program by
calling 877-505-6986. You will need to have patient’s insurance information available when you call. This
program will take off $200 from the patients co pay for up to 30 day supply. (Gilead will provide billing ID#,
Bin #, and Group# over phone for this co pay assistance for the pharmacy). For patients who have a higher
co pay or an annual deductible that has not been met, can appeal for assistance by calling Gilead at 800-226-
2056. This appeal process can take hours as is refered to their leadership at Gilead for approval. (If going
through appeal process they may want pt to complete their formal application that is used by patients
applying for ongoing Truvada assistance such as HIV positive patients. This application can be obtained at
800-316-6857 or rxassist.org.)

MEDICATION: ISENTRESS
PHARMACEUTICAL COMPANY: MERCK
Some patients are unable to be treated by Truvada alone and the recommended med the NP or MD may want
pt to take in addition is Isentress. This company will attempt to assist asap. They have reported that
application for assistance must be made via submitting the application which has a prescription section on it
(application can be obtained by calling the company at 800-850-3430 or at rxassist.org) by fax to 866-410-
1913 by marking the fax cover sheet with “URGENT EXPOSURE”. No proof of income needed but income
must be reported on application. Wait one hour after faxing and then call them (800-850-3430). They take
case by case and will overnight ship the medicine to the MD office or the patient’s home, whichever is
preferred. Shipping for overnight must occur before 12:30pm our time to get there the next day—shipping
over weekend does not arrive overnight.
Co pay assistance coupon can be activated and printed off for patient from Isentress.com website for $400 off
prescription.
MEDICATION: COMBIVIR
PHARMACEUTICAL COMPANY: ABBOTT (VIIV)
Medication can be obtained same day by calling 877-784-4842. Follow same instruction that is listed for
Truvada. The fax # is 877-784-4004.
MEDICATION: KALETRA
PHARMACEUTICAL COMPANY: ABBOTT (ABBVIE)
Patients who are prescribed Kaletra are not able to get same day meds (similar to Isentress. However, you
can obtain the application for assistance from the company at 800-222-6885 or via rxassist.org, complete the
application (no proof of income needed) and fax to company marking “URGENT EXPOSURE”, wait one
hour and call them for processing and they will send meds asap but not overnight. This is a case where you
might want to keep samples on hand to get the pt started. You can check to see if there is a pharmaceutical
rep that can help you with this at 800-441-4987 option 1. Co pay assistance cards can also be obtained for
$200 off co pay by contacting company.
IF OTHER MEDS ARE USED IN COMBINATION WITH ISENTRESS, YOU CAN LOCATE THE MED,
COMPANY, APPLICATION AND CONTACT INFO AT rxassist.org.

Source: http://www.incasa.org/PDF/2013/HIV_Medication_Assistance_Following_Exposure.pdf

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