Treatment Issues Vol. 11, no. 2

Any pharmacy or provider interested in dispensing indinavir can register with Merck. Participating pharmacies will report certain
identifying patient information so Merck can
continue to monitor and control distribution.
This is referred to as "enrolling" patients and is
being handled through a subsidiary of Merck
called PAID Prescriptions. The participating
pharmacy will only receive a month's supply of
indinavir for each enrolled patient after transmitting the pertinent information to PAID (via fax,
phone or computer network). Pharmacies must
also confirm with PAID each month that the
patient needs to refill an order before the medication will be shipped (PAID will fax a reminder
to the pharmacist).
It is therefore very important to make sure
the pharmacist requests the refill in advance so
that it will be ready to be picked up when
needed.
According to a Merck spokesperson, indinavir will not be going into normal distribution
in the foreseeable future. Merck states that special measures are still necessary in order to
insure all patients have uninterrupted access to
the drug. Although production has increased,
supplies must still be closely monitored due to
demand in nations where indinavir is newly
approved. (Indinavir has been approved in 49
countries to date, the most recent being Albania).
Those patients already enrolled and receiving
indinavir through Stadtlander's may continue to
do so by simply filling out the monthly refill
cards as usual. No one is under any obligation to
continue using Stadtlander's, and those who
wish to switch will be able to mark a box on the
April refill card to that effect. These people
should then enroll with another pharmacy and
make sure there will be no problems with insurance coverage. A new paper prescription will be
required in most cases by the new pharmacy, but
doctors will not have to call to enroll patients, as
was the case in the past. New patients just beginning indinavir can sign up with their participating pharmacy of choice. Note that there may be a
two or three day delay between enrolling and
receiving indinavir for the first time.
Anyone who needs help enrolling in the distribution program, locating a participating pharmacy, or obtaining financial assistance should
call 888/CRIXIVAN.
Viral Load Patient Assistance Programs
Both Chiron and Roche have set up patient
assistance programs (PAP) to ensure there is

access to viral load tests for those who have no
current means of payment.
The number to call for information (in English or Spanish) for the Roche program for PCR
tests is 888/TEST-PCR. The PAP representative
will first determine whether the caller is eligible for coverage through an insurance company and will assist in negotiating with that
carrier. If third-party reimbursement cannot be
arranged and the applicant is qualified, Roche
will send the applicant's doctor a voucher for a
free test, along with the address of the laboratory designated to perform the test. There is
supposed to be a two week turnaround time
from initial call to approval for those who qualify. Eligible patients are entitled to a maximum
of five free tests per calendar year and must go
through a simplified recertification process for
each additional test.
The number to call for information on Chiron's bDNA PAP is 800/775-7533. This is the
reimbursement hotline, which assists people in
finding payment methods and working out
problems with claims (prior to April 15, 1997
inquiries about the PAP can be directed to
888/HIV-LOAD) The bDNA test is still not
FDA-approved, but, according to a survey
done by Chiron, most claims are being paid for
by private insurers, Medicaid or ADAP. For
those who have no means of payment, Chiron
is working with certain local hospitals and clinics that serve indigent or uninsured patients to
provide free tests on site. This means that a
person must register with a participating medical facility in order to have access to the program. Facilities are being targeted in large
urban areas with several sites already on line in
San Francisco, Los Angeles, Boston and Chicago and others planned in cities with large populations of people living with AIDS. The
program is not available to those outside the
immediate geographic area.
One final note for those who had PCR tests
performed last summer under Roche's free
introductory program and never received the
results due to a massive logjam at the labs
involved: Roche is still offering two complimentary replacement tests (see Treatment Issues,
November, 1996, page 12). Physicians can
request coupons for patients in this situation
until the end of June. The coupons are valid for
six months from date of issue and can be unofficially transferred to any patient. Doctors can
also call the PAP number, 888/TEST-PCR, to
obtain the coupons.

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