Academy Exchange

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  • 1.  billing

    Posted 01-31-2022 10:40
    Good Morning,

    I run a new pharmacy clinic in Silver Spring MD and I am helping an HIV patient. I received a prescription for Biktarvy.
    I tried to order it from my primary supplier and the price is $3512.13 for 30 pills. This is just the cost to obtain the medication without including a dispensing fee. Patient has no insurance and will not be able to pay. what should I do?

    Please help,


    Nicodimos, PharmD, BCPS, AAHIVP

    Wasihun Nicodimos
    RX Clinic Pharmacy
    Silver Spring MD

  • 2.  RE: billing

    Posted 01-31-2022 15:08
    Yes , that's your acquisition price. If no insurance guide them to nearest HIV  clinic/ hospital. So they can be in touch with case worker. They will look into all possible options either Ryan White program or Mfr sponsored MAP/ PAP program.

    Gangadhar Revuluri
    Galaxy Specialty Pharmacy
    San Antonio TX

  • 3.  RE: billing

    Posted 01-31-2022 15:19

    Order the med to minimize delays in therapy, you may be able to get billing sorted out today.

    Each HIV manufacturer has their own manufacturer patient assistance, and I'd recommend becoming familiar with each of them and also with your local reps/MSLs. Your MSLs are going to be your best friends. 

    For Biktarvy, you may be able to utilize the Gilead Advancing Access Program. If there's a clinic you're working with, you can ask to be a part of their iAssist program for easier enrollment, otherwise you can utilize the faxes. Without iAssist, you can call Gilead's AAP and try for immediate conditional approval which would cover #30 for no copay (they allow a refill every 23 days so you could get two fills under that conditional approval). This is a great option for patients only on the one med, but I'd still recommend the patient be partnered with a benefits navigator to either enroll in state assistance or ADAP. 

    Is this patient new to ART or is this a continuation of therapy? If a continuation how were they getting Biktarvy before? 

    Ashley McClure-Wolfson
    Chicago IL

  • 4.  RE: billing

    Posted 01-31-2022 15:23
    Patient will need to enroll in ADAP to get free medication and also that will cover his labs as well.

    Lucy Efobi, AAHIVS
    New Jersey

  • 5.  RE: billing

    Posted 01-31-2022 15:24
    This is a common problem and I have usually in the past used the patient assistance programs.
    I would first check this link to see if this patient qualifies. They may need their physician to assist but sometimes that may not be required.
    Gilead Patient Assistance Program for the Uninsured
    Gileadadvancingaccess remove preview
    Gilead Patient Assistance Program for the Uninsured
    By following this link, you are leaving this Gilead website. Gilead provides these links as a convenience. But these sites are not controlled by Gilead. Gilead is not responsible for their content or your use of them.
    View this on Gileadadvancingaccess >

    If they don't qualify I would reach out to Angelique Griffin at she may cover your area or be able to direct you on who can help.


    Leonard Sowah
    Baltimore MD

  • 6.  RE: billing

    Posted 01-31-2022 15:34