RITONAVIR: Liquid Form Means Higher Copayments
"Out-of-pocket" copayments for a number of HIV-infected patients have risen dramatically as a result of Abbott Laboratories' production method change of protease inhibitor Ritonavir from capsule to liquid form. The Washington Blade reports that pharmaceutical delivery firms Merck-Medco and Caremark have discontinued shipping Ritonavir because the liquid form of the drug must be stored at room temperature, and "they could not guarantee the integrity of the drug if they ship it by mail." As a result, Blue Cross-Blue Shield is requiring patients to fill their prescriptions for the drug at retail pharmacies, forcing them to pay as much as $100 a month or more for the drug. The Washington Blade reports that Merck-Medco is the only shipping company for Blue Cross-Blue Shield's health insurance plan for federal government employees, which covers 3 million people, or 45% of the federal government workforce. One Blue Cross client told the Blade that his monthly co-payment of $8 for ritonavir capsules under Merck-Medco's delivery program rose to $233.33 per month for the liquid form -- 20% of the drug's retail price. Through negotiations by the federal employee plan for Blue Cross, a discounted price for the liquid form lowered the monthly copayment to $78, but the client says "he believes it is the responsibility of his insurance carrier to maintain its original co-payment rate for prescription drugs." The Blade reports that while at least two other companies ship the liquid form of the drug in special packaging, Merck-Medco does not use that packaging, and Blue Cross official Bill Pierce noted that the insurer "has an exclusive contract with Merck-Medco" (Chibbaro, Washington Blade, 11/6).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.