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  • 1.  Introducing the Long Acting Agents Discussion Forum

    Posted 04-26-2022 12:30
    Edited by Dan Ebeling 04-27-2022 15:47

    I’m very excited to announce that we’ve just launched our second discussion board on the Academy Communities platform, the Long Acting Agents Discussion Forum.  This discussion thread is focused specifically on Long Acting Antiretroviral Agents (LAA) and is the first in a set of resources for patients and providers that will be coming out over the next year around this topic.


    If you are currently prescribing LAAs, or hope to in the future, I encourage you to join the conversation in this forum.  By joining, you’ll get a Daily Digest e-mail with activity updates, similar to the one you get for the Academy Exchange.


    Joining the LAA Discussion Forum is easy.  Simply navigate to the main Academy Communities page, log in, then select “JOIN” next to the LAA Discussion Forum on the left side.


    If you have any questions about joining this community, please don’t hesitate to contact me directly at


    I hope to see you in the LAA Discussion Forum!

    Dan Ebeling (he/him)
    Academy Communities Admin
    Director of Credentialing and Technology
    +1 (202) 659-0699

  • 2.  RE: Introducing the Long Acting Agents Discussion Forum

    Posted 04-26-2022 22:57
    I hope others are more successful than we were here at crossroads virology where we blasted off last March and put 11 patients on cabenuva and lost nearly $75000 before the calendar year was done getting way underpaid by BCBS, Aetna, and others. I had an employee spending 8-16 hours a week on these while getting threat emails from the wholesaler we owed money to.
    After working with ViiV support on a weekly basis, we still couldn’t even break even and now we have had to switch them all back to pills after using almost all of our 340b money to cover the losses. We tried switching from “buy and bill” to “brown bagging” ( specialty pharmacy bills for and sends the Cabenuva), but now Walgreens has told us they can’t work with Cabenuva either!
    We realized this was hopeless when we met with an infusion company who said they had hundreds of clients they worked with and none were making money with Cabenuva.
    It’s a great drug but I can’t help anybody when we have to go bankrupt.
    Hard to believe we thought we were being heroic but now we are just feeling broke and stupid. The huge financial loss and inability to provide it has demoralized all of us badly.
    Crossroads Virology medical director

    Sent from my iPad

  • 3.  RE: Introducing the Long Acting Agents Discussion Forum

    Posted 04-27-2022 20:20


    This is discouraging. I have roughly 20 patients on Cabenuva. Our biggest issue is getting it delivered in a timely manner. When the oral lead-in was required, and I was not a preferred provider, ViiV would refuse to release the goods. I would have to contact the insurance company and go through channels to get an approval code to release that oral lead-in. I had no idea about the financial demise.


    Amber Siegel DNP AAHIVS
    Crew Healthcare
    Orlando, Florida

  • 4.  RE: Introducing the Long Acting Agents Discussion Forum

    Posted 05-06-2022 15:36
    Wow, that's interesting! Have you reached out to your Viiv field reimbursement manager about this? I'd be happy to connect you with ours to determine the next best steps. 

    At my practice site, we are currently only utilizing specialty pharmacies rather than buy and bill out of similar concerns. We are looking into buy and bill, and the Viiv FRM that I work with suggested contacting each insurance plan for each individual patient prior to intiiating to determine what their reimbursement rate will be. We haven't had much luck getting a concrete number back from them yet though. 

    Caitlin Prather
    Falls Church VA

  • 5.  RE: Introducing the Long Acting Agents Discussion Forum

    Posted 05-06-2022 17:02
    Yes we had so much of a headache dealing with specialty pharmacies from hep c drugs, we thought we could avoid those problems ( drugs arrive late, sent to wrong address, etc ) with buy and bill but 10 months later we are out of business and closing in November, hopefully able to pay off McKesson by then with 340b money.
    Now we are being told by one of the BCBS specialty pharmacies is not even able to " brown bag ", so only 2 patients' insurance found a way to get them Cabenuva. All the others had to change back to pills.
    Losing all that money is no big deal if you are a govt. agancy but as a solo practice doc treating HIV since 1996, its a mortal wound that we lost too many employees and too much money to survive. Be sure to have a plan B and samples available just in case...
    At least we will be able to stay open long enough to have a plan for our 110 patients, but they will likely have to drive at least 90 miles for DSHS help, etc. 
    It is so depressing as we really were ready to lead the way to injectables and work at least 25 more years.
    Have a plan B and dont let yourself go into too much debt that you cant get out!

  • 6.  RE: Introducing the Long Acting Agents Discussion Forum

    Posted 05-09-2022 10:03
    We have been very fortunate to develop a relation with Bioscript/ option care.  they are an infusion company that we have used in the past for Rocephin and bicillin injections.  they have been able to administer LA HIV treatment to most of our patients.  they do the authorization, set up the appointment and administer.  they let us know when injection was given ( we have to sign the billing paper work) and also contact the office if they can not reschedule a patient that missed.  they will also bill our state's ADAP for co-pays  if the patient is enrolled.  I have sent them 12 and they were able to serve 8.  not perfect but is a resource.  for those that work closely with ID, ask who they use for their IV infusions and consider asking if that infusion company would be interested in administering LA HIV ARV  and if you have a bioscript local try them,  I understand it is a national program for them

    Christine Brennan
    LSU Health Sciences Center
    New Orleans LA