Prices can vary depending on the state, purchaser, type of public or private insurance coverage in use, and number of generic competitors to branded drugs (see Table 22b below). Prescription drug pricing in the United States involves complex systems with varying requirements for mandatory and voluntary discounts, rebates, and reimbursement rates, and much of the pricing information is confidential. Providers should make every effort to prevent cost from limiting HIV care. Overall costs to the health care system, to insurers, and to society are also important, especially given the increasing number of people with HIV, rising drug costs, and increasing multimorbidity among people aging with HIV. The cost of ART, especially out-of-pocket costs to the patient, should be one of the many considerations in regimen selection, because such expenditures may directly affect adherence. This section provides guidance on cost considerations related to HIV clinical care. 13,14 Consequently, ART was among the top five therapeutic classes in nondiscounted spending on medications in 2018, after medications for diabetes, autoimmune diseases, cancer, and respiratory disorders. Total annual undiscounted spending on ARV drugs has more than doubled since 2010, reaching $22.5 billion in 2018. 10 These guidelines first included an antiretroviral (ARV) cost table in 2012, 11 and since then, the overall cost of brand-name, first-line ARV regimens has increased by more than 30% from 2012 to 2018, 12 which is 3.5 times the rate of inflation for that same time period. 9 The estimated total direct expenditure for HIV/AIDS care and treatment between 20 was $10.7 billion annually, which is 800% to 900% higher than similar expenditures for other chronic conditions. A 2015 study using 2012 health care expenditure data estimated that the discounted lifetime medical costs for an individual who acquires HIV at 35 years of age is $326,500 ($597,300 undiscounted), with 60% of the costs attributable to ART. 7,8 However, HIV treatment with ART is costly. The clinical benefits, public health impact, and cost-effectiveness of HIV treatment have been well established since the advent of combination antiretroviral therapy (ART), 1-6 and the expanded use of ART is one of the four pillars of the Ending the HIV Epidemic in the U.S. Please do not fax.Ĭall for most recent medications as the list is subject to change.Limitations to Treatment Safety and Efficacy Cost Considerations and Antiretroviral Therapy Individuals who do not meet the insurance criteria may still qualify for the Merck Patient Assistance Program if they attest that they have special circumstances of financial hardship, and their income meets the program criteria. Patient requests refills via a toll-free numberĪt Merck we realize that sometimes exceptions need to be made based on the patient's individual circumstances. Must be residing in the US or a US territory, and under the care of a US physicianĬomplete section, sign, attach required documents fosaprepitant dimeglumine injection iv.doravirine-lamivudine-tenofovir disoproxil fumarate tablet.metformin-sitagliptin tablet extended release.HIV Common Application: Merck Patient Assistance Program Merck Patient Assistance Program Brochure Merck Patient Assistance Program Enrollment Form (Spanish) Merck Patient Assistance Program Enrollment Form Provided by: Merck Patient Assistance Program, Inc. Merck Patient Assistance Program This program provides brand name medications at no or low cost
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