IDSA and HIVMA are working with the National Coalition of STD Directors and Treatment Action Group to address supply and cost issues affecting the response to the growing STI epidemic. We are particularly concerned about access to Bicillin-LA, manufactured by Pfizer Inc, following a drug shortage in 2017 and the cost of the drug for providers without access to 340B.
Providers and health departments report challenges stocking or accessing the drug and other barriers that have inhibited care for patients diagnosed with syphilis. The price of the drug can be a barrier to clinics stocking the drug and to patients being able to afford the cost sharing associated with it. Although health departments have access to Bicillin-LA under the 340B Drug Pricing Program, not all patients are able to benefit from this.
Providers also have reported that the cost of three site testing mouth, genital and urinary systems, and rectum for chlamydia and gonorrhea can be another barrier to appropriate STI treatment and prevention.
Examples of real-time barriers will help to inform our work advocating with federal agencies and drug manufacturers to develop practical solutions to these challenges.
Please let us know in an entry below if you, your hospital/clinic, health department, or patients have experienced any of the issues below:
- Accessing any formulation or dosing of Bicillin-LA from the manufacturer or wholesaler.
- Accessing other STI treatments or dilutants, such as lidocaine.
- Being advised to monitor prescriptions by your institution because drug backorders may be unavailable.
- Having to use alternative therapies for treatment of primary, secondary, or congenital syphilis.
- Having patients receive no treatment due to drug availability or cost.
- Being unable to receive Bicillin-LA at 340B price after sending patients to the health department.
- Receiving insufficient reimbursement from private insurance, Medicare, or Medicaid.
- Minimum drug purchasing requirements due to multi-dose packaging being a barrier to keeping Bicillin-LA in stock or resulting in wasted doses and money lost following drug expiration.
- Patients not being screened for STIs due to cost.
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