This week’s episode, which is called Ready Set Prep. Not so fast. This week the Department of Health and Human Service is announced their great initiative, called Ready Sit Crip, which is going to be the program to provide print for free to people across the United States who qualify for prep that are uninsured on the surface and on the face of it, this is a great initiative and a great program, and the goal off the government is, too.





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  • What are the holes in Ready Set PrEP
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Welcome to this week’s episode, which is called Ready Set Prep. Not so fast. This week the Department of Health and Human Service is announced their great initiative, called Ready Sit Crip, which is going to be the program to provide print for free to people across the United States who qualify for prep that are uninsured on the surface and on the face of it, this is a great initiative and a great program, and the goal off the government is, too. In the HIV epidemic, it’s a great goal.

It’s something that we need to strive to, and while we know treatment is prevention, so people getting tested and getting on HIV treatment right away is really important because we know when people have an undetectable viral load, they cannot transmit the virus. So we have to call that undetectable is an untransmittable campaign very important. So treatment is prevention, but also people at risk for getting HIV can take Prep. So either Truvada or Disco V, which are the drugs approved for Prep right now in the U. S. Provided to prove for everybody and discover he’s approved for four men and cross-gender women. But not at this time for sister and a woman, those two drugs or the drugs that are approved for the press in the United States.

So with the U. S. Department of Health and Human Services campaign to reduce the number of infections dramatically in the United States of decreasing it by 75% in five years and by 90% in 2030 these prep initiatives are really important. So while the drugs are extremely costly, Gilead has donated Disco V and Travolta as part of this HHS program Ready set prep to provide the drug for free for those people that have no insurance. So while this sounds extremely amazing that people with no insurance can have access to prep. There are some issues that we need to address first, to make sure that people getting access to this program have, as a continuous medical service, is access to lives and things like that. So while the drug might be provided for free. So on this at the end of this podcast on the transcript in the Resource is section we’ve got links to all the websites that are part of the ready set prep program.

But while Gilead provides drugs right now for free to those that are uninsured through their granting Access patient Assistance program, this program through HSS, kind of partners with advancing access. But it goes through the website that I assist website. So the links on the bottom of this. But with this, you know, healthcare professionals or individuals wishing to sign up get logged into the Isis program, and then you go through the initial application online. So I hit after reading all the information and going through all the websites extensively getting on multiple checks with I assist courting, advising excess and spending 30 minutes on the phone, then calling HHS and spending time on the phone with them.

I’ve got a clearer picture of the mechanism of the house. This is gonna work because it is a pharmacist providing prep and ensuring the adherents of our patients every month to get access to the president? They’re taking the medicines and that they’re getting adequate medical care. It was really important for me to see Look, what is the actual mechanism of this? So what the government still a great job in providing the drug for free as a zit were? What about the rest of the medical service is How are patients with no insurance? Going to get access to medical service is so somebody who’s going on print it has to be tested for HIV to make sure that the HIV negative. They have to have a plethora off test for prep to determine other things.

Do they have hepatitis B? If it’s a woman? Is she pregnant and ongoing test like every three months to make sure they don’t sirrah convert while they’re on the prep. Access to adequate pharmacy service is adherence, counseling and those types of things so well they could be enrolled in the program to get prepped for free we’re going to get these medical service is so while this ready sick trip program addresses the physical excess of the drug for free, doesn’t really address medical service is. So while they Ryan white clinics across the country and clinics that I would assume would take care of these patients. The government hasn’t really addressed funding or the burden that is placed on these free clinics, so to speak, to take care of these patients. No private practice physician that I, I’m aware of or could think of is gonna see patients that are uninsured and then work to get them on these programs to get the grub for free, these patient assistance programs and things like that. So that’s a big floor in the program is while the drug end of it might be free, where is the patient going to get the medical care from? So that’s one thing.

The other thing that when I called both advancing excess and the HHS to find out more about the program, is when the patients enrolled through. I assist. What’s the difference between I assist and the advancing access program? So it wanting excesses, Gillian’s patient assistance program and currently they take care of patients that have no insurance and qualify for the patient assistance program. So this Isis program, which is kind of part of Gilead’s influencing access program because it’s a Gillian program, is a separate application, so to speak. So, for instance, if somebody has been part of an advancing access program within the last 12 months, they would not be eligible for this ISIS program.

So that person, whether they underinsured or uninsured, would be getting the Travolta or Discovery through advancing access, just like they were. The ISIS program is with somebody who’s within the last 12 months has not been part of the Gilead Patient Assistance program, and he’s somebody who has no insurance can then be enrolled online. One of the cave yards to the online application is that it does require a Social Security number. So when I called HHS, one of my questions was, well, many patients that we have maybe undocumented or don’t have a Social security number, So a on those patients going to be rejected from the program and unable to enroll and B, when the website requires a Social Security number to enroll the patients how we gonna, enroll them online because they have no Social Security number? And what she said was that patients will not be turned away Patients who are undocumented. I don’t have a Social Security number. You cannot do the application online, but you can do the application, the effects.

So I’ve included the facts and I’m being the resource is as well. Um, for those patients of ours that may be undocumented or don’t have a Social Security number to be able to be enrolled in this program so they are required to be living in the United States. So have a United States address. Social Security number is not necessary and they will qualify for the program. So when we enrolling patients in the really said Pray program, they will then be eligible for 365 days, so for an entire year of access to prescriptions through the program. So if you do the application online, you can get the I. D number and the PC and in the bin number almost right away. When you’re doing the application for those patients of ours who don’t have a social security number, however, and we have to do the application by fax that can take up to two business days to get approval for a patient and get the required PC and Ben and I D number that the pharmacies would require. So then came my biggest question of all.

What about pharmacy Xs on the website and on all the resource is and Patient Resource is for the already separate program and said that the patients can use a pharmacy of their choice. When when I spoke to advancing access, the agent made mention that a lot of people are complaining because they being told that only CVS, Walgreens or Rite Aid or the pharmacies that are providing the service, she said. That is absolutely not true, and the patient can go to any pharmacy of their choice. So our patients utilizing any local independent specialty pharmacy, HIV pharmacy or any pharmacy that they choose, they’ll be allowed to get the prescriptions there because they’ll be provided with PC and have been in an ID number for themselves, just as happens through the advancing access program. Currently, one of the things on the press release that was released on December 3rd for the really set prep program is and I’ll re-read it out to everybody, it says.

Recognizing the importance of expanded access to HIV print medications, CVS, Health, Walgreens and Rite Aid have donated their dispensing service is to H ages beginning no later than March 30th 2020. As part of these donations, qualified patients can obtain the prick medications at more than 21,000 combined CVS Health, Walgreens and Rite Aid locations throughout 50 states. The District of Current Colombia, Puerto Rico and the U. S Virgin Islands. Through mail order, all at no cost to the patients, these pharmacies represent about 1/3 of all pharmacies in the United States. CVS Health, Walgreens and Rite Aid will also provide patient counseling and take steps to promote patient adherence to the regimen. Between now and March 30th, 2020 patients will be able to access prick medications through these programs and thousands of participating pharmacies. Now I have a major issue with this paragraph in this press release.

First of all, this mess of big box stores have and you can’t see me, but I’ve got a quote donated. The dispensing services were, quite frankly, or pharmacies in pharmacies that I’m associated with and or pharmacies that I know currently are donating their dispensing service is because all the reimbursements that we’re getting from insurances and PB EMS, especially PBM sack CVS Cup Caremark, owned by CVS Health our reimbursing pharmacies negatively on most prescriptions, especially HIV prescriptions. A very, very high percentage of those so clearly all of us pharmacists working in many of these pharmacies are clearly donating out dispensing surfaces. And then to make this statement of donating dispensing service is what does that really mean? Because when the prescriptions processed with the PC and been number from the really sick prep program that pharmacy, whether it’s serious health, Walgreens, Rite Aid or Joe’s Pharmacy on the corner is getting reimbursed through their program for the drug that they purchased and are providing.

So this seems very misleading, and I can see where this could be an area where people are getting confused. Now, do I have to go to CVS, Walgreens, and Rite Aid? So on the one hand, HHS is saying the patient can go to any pharmacy they want and now in the pressure released, I’ve got this whole paragraph about these three big box stores, so that’s extremely misleading. Here in California, we have the passage of SB 159 and from July next year, trained pharmacists will be eligible to provide 60 days of prep and to provide pip to patients coming to the pharmacy. Pharmacists and community pharmacists are perfectly poised to be the providers of prep. We are health care providers. We provide excellent service and trained pharmacists, and people in HIV pharmacies can provide exceptional HIV counseling discussions on adherence I provide an advantage. Practice service is as well through my boot too far Mrs. Care program and patients are taking care off. So this paragraph in this press release I take great exception to because it’s very, very misleading. So what I know this minute is and what I’ve been told by HHS and the Gilead Advancing access programmed today is that the patients can get the prescriptions filled at any pharmacy and just like everything for Mrs have to be trained. They have to know what what they doing. They have to understand HIV.

They have to understand prep, and they have to understand the whole process of the prick guidelines to keep people on print to keep them HIV negative and make sure they continuously go to the doctor and get the labs. So again, that brings us back to what we discussed in the beginning, even though we can provide the drug for free to people, how they’re going to get access to the medical service is so That’s very serious caviar to this whole thing. And we must ensure the entire continuum of K and access to care for our patients, not tiny little pieces with blinkers on like they can get the drug for free, but they have no access to seeing a provider. Getting access to the blood work and pay and pay for that service is many of our patients who would have to access the really said prep program.

Don’t have the resource is to pay for doctor’s visits to pay for labs. It’s secret, especially every three months. So again, this brings us to be conscious in every program, whether it’s a program in a pharmacy within our local community city, in our community, in a state and federally across all 50 states, as well as the Virgin Islands and Puerto Rico, it is really important that we are conscious and we look at everything from a 360-degree view so we can address all the issues, not just provide the drug for free. But do they have access to health care and layup? Service is as well. So we have to be conscious. We have to take your patients through this lens off, looking at everything again. We have to be conscious and remember to only pharmacists that they be the change.