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Medicaid and ADAP Access to Peginterferon and ribavirin
  source: http://www.atdn.org/hcv.html, AIDS Treatment data Network
Due to the budget crisis facing most Federal and States' drug assistance programs, and the high cost of treatment, coverage for pegylated interferon and ribavirin will be hard to come by. We provide some options for people who need to go on HCV treatment now but have no way to pay for the drugs themselves. This is a patchwork coverage at best, it is by no means universal. Following are some ways to make best use of what is available:
Medicaid - The federal insurance program for the poor and disabled is required to cover all FDA approved treatments. Currently, all 50 Medicaid programs cover Peg-Intron and ribavirin. Only 9 cover Pegasys so far. Check with your Medicaid for eligibility criterias.
ADAP - Currently, only seven ADAPs (AIDS Drug Assistance Programs) covers Peg-Intron and ribavirin for people co-infected with HIV and HCV. They are: California, Connecticut, Delaware, New Hampshire, New Jersey, Massachusetts, and Virginia. In addition, New York covers ribavirin but not Peg-Intron.
For eligibility criterias, See the Access Project database at www.atdn.org/access/states/index.html. People who live in states where the ADAP does not cover HCV treatment can apply to the programs listed below.
Schering's "Commitment To Care" Program for Peg-Intron and Rebetol (ribavirin) - This program will help you identify ways to get the drugs paid for. If your private insurance does not cover the drugs, and you do not qualify for Medicaid, or your ADAP does not cover Peg-Intron and Rebetol, Schering will supply a full 48-week treatment of the drugs for free. Eligibility ranges between 200% to 300% of the Federal Poverty Level (Currently $17,720 and $26,580 annual income for an individual, respectively), depending on where you live. Call 1-800-521-7157 to enroll.
Everyone, regardless of the ability to pay, must still register with Schering's "Access Assurance Program" in order to get Peg-Intron. However, the previous supply shortage has now been resolved and there is no longer a waiting list to get the drug. Schering plans to phase this program out as soon as they are certain there will be no supply problems. The phone # for Access Assurance is 1-800-437-2608, or go to www.access-assurance.com.
Roche's "Pegassist" 12-week free sample program - Roche will be providing physicians with samples of Pegasys for the first 12 weeks of therapy.
These samples will be provided at the request of a physician for the first 15,000 patients who apply prior to December 31, 2002. Pegasys is available by prescription with no registration requirements. Call 1-877-pegasys or go to www.Pegasys.com.
After the first 12-week supply, patients who make less than 300% of the Federal Poverty Level ($26,580 annual income for an individual) and have no other medical coverage, or if their state's Medicaid does not yet cover Pegasys, are eligible for Roche's Patients' Assistance Program by calling Pegasys' reimbursement Hotline 1-800-387-1258. Roche says no one on Medicaid will be turned down if their state has not yet added Pegasys to the Medicaid formulary.
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