GlaxoSmithKline announced this week that it has introduced a cash savingsprogram for its protease inhibitor Lexiva® (fosamprenavir).  The new “Patient Support Cards” will provide someHIV-positive patients with a “credit” of up to $50 toward theirout-of-pocket expenses for Lexiva, every time their prescription forthe drug is filled for a totalof two years.

Lexiva, combined with Norvir® (ritonavir), is one of several “preferred” antiretrovirals listed by the U.S. Department of Health and Human Service (DHHS) it its Guidelines for the Use of Antiretroviral Agents for HIV-1 Infection Adults and Adolescents. This coveted title is based on results from clinical trials, indicating that it is one of the most effective options to choose from for HIV-positive patients starting therapy for the first time.

With a growing number of "preferred’ options to choose from, cost has become a factor among patients in terms of deciding which treatment regimen to choose and stick with.  For example, a typical private insurance copayment for 30 days of Kaletra® (lopinavir coformulated with Norvir) is $25.  Combined with, say, Truvada® (tenofovir coformulated with emtricitabine), which carries a typical copayment of $25, the total out-of-pocket copayments for the complete regimen on a monthly basis would be $50.  Norvir-boosted Lexiva, with both drugs dispensed separately, may carry copayments of $25 each.  Combined with Truvada, the total out-of-pocket expense would be $75.

“To help improve patients’ adherence to their drug regimens,” Michael Joyner, Director of HIV Communications and Advocacy at GlaxoSmithKline writes in a recent letter to HIV community advocates, GSK is offering Patient Support Cards to defray “out-of-pocket prescription costs for patients beginning treatment with Lexiva, or who are currently on an HIV treatment regimen that includes Lexiva.”

Individuals eligible for the program, which officially began in November 2006, is for patients paying out-of-pocket prescription costs, including those who have private health insurance copayments and those covering the entire cost of their drug regimen themselves.

HIV-positive patients whose prescriptions are covered by Medicaid, Medicare, ADAP or any other Federal or State assistance program, do not qualify for the program.  Moreover, residents of Massachusetts are eligible only if their Lexiva prescription is not covered by any insurance or assistance program.

According to Mr. Joyner, the new cards will be of significant benefit to approximately 40% of those currently taking Lexiva.

Patients eligible for the program will receive the card from their healthcare provider and will need to present it to their pharmacist, along with their prescription for Lexiva.  According to Mr. Joyner, these cards will cover out-of-pocket expenses of up to $50 every time a Lexiva prescription is filled, or refilled, at any pharmacy in the United States for a total of two years following activation.

For uninsured patients paying the full price of Lexiva, the card will provide a $50 discount off the retail price.  For patients with private insurance, the card can be applied toward the Lexiva copayment.

“This is clearly an effort to level the playing field with Kaletra,” says Paul Dalton, Treatment and Research Advocate at Project Inform in San Francisco.  “I don’t think it will end up enticing many people to switch, but it might help some people make a less economically based decision between Lexiva and Kaletra.”