Showing posts with label Merck. Show all posts
Showing posts with label Merck. Show all posts

Thursday, July 18, 2024

HIV LONG-ACTING INJECTABLES: Patient Access Considerations for Injectable HIV Therapies & Injectable HIV Pre-Exposure Prophylaxis

By: Brandon M. Macsata, CEO, ADAP Advocacy; Jen Laws, President & CEO, Community Access National Network (CANN); Marcus J. Hopkins, Founder & Executive Director, Appalachian Learning Initiative (AAPLI); and Riley Johnson, LGBTQ Health and HIV Policy Consultant

On June 26th, after nearly one year of community engagement, ADAP Advocacy published its final report, HIV LONG-ACTING INJECTABLES: Patient Access Considerations for Injectable HIV Therapies & Injectable HIV Pre-Exposure Prophylaxis

Final Report Cover - HIV LONG-ACTING INJECTABLES: Patient Access Considerations for Injectable HIV Therapies & Injectable HIV Pre-Exposure Prophylaxis
Photo Source: ADAP Advocacy

In pursuing this project, ADAP Advocacy sought to understand patient perspectives on long-acting injectables (LAIs). This occurred through three methods – a quantitative survey, a qualitative focus group, and an examination of data – across two populations – those who are HIV-positive (the use of LAIs for treatment) and those who are HIV-negative (the use of LAIs for prevention). This project was made possible by support from Gilead Sciences, Merck, and ViiV Healthcare.

ADAP Advocacy received 305 responses to the Perspectives Survey on LAI Treatments for People Living with HIV (“Treatment Survey”), which resulted in a total of 262 eligible participants from 38 states, the District of Columbia, and Puerto Rico. In addition, ADAP Advocacy conducted a post-survey focus group with 8 participants to further explore patient awareness and knowledge of, perspectives about, and access to LAI treatment options. 

ADAP Advocacy received a total of 184 responses to the Perspectives Survey on LAI HIV Prevention Medications (“Prevention Survey”), which resulted in a total of 154 eligible participants from 35 states, the District of Columbia, and Puerto Rico. ADAP Advocacy conducted a post-survey focus group with 8 participants to further explore patient awareness and knowledge of, perspectives about, and access to LAI prevention options.

The findings from this project serve as a starting point for ADAP Advocacy to conduct additional patient-centric research to learn more about the barriers as well as facilitators faced by patients seeking LAIs. This project’s research questions concerned patient treatment preferences, information pathways, utilization, and barriers to access. 

 Key findings include:

  • The majority of respondents to the Treatment Survey (52.3%) indicated that they would prefer receiving LAI medication to treat their HIV over a daily pill-based regimen; In the Prevention Survey, the majority of respondents (71.4%) indicated they would prefer an LAI over a daily pill-based regimen to prevent HIV.
  • The vast majority of respondents to the Treatment Survey (87.8%) indicated being aware of Cabenuva as an LAI to treat HIV. Of those respondents who learned about the existence of LAI medications through this survey, half (50%) reported being open to discussing them with a medical provider; Just over half of respondents to the Prevention Survey (58.4%) indicated being aware of Apretude for use as LAI PrEP. More than four out of every ten respondents (42.2%) who learned about the existence of Apretude through this survey reported being open to discussing it with a medical provider;
  • A majority of respondents to the Treatment Survey (87.7%) indicated having no issues finding information about LAI medications. Of those respondents who did have trouble finding information (12.3%), most respondents had trouble finding information about insurance coverage (78.6%), prior authorization requirements (78.6%), and the cost they would have to pay to access LAIs (71.4%);
  • Insurance coverage barriers impacted respondents’ ability to pursue LAIs, with more than 1 in 4 survey respondents (27%) reporting this barrier in the Treatment and Prevention surveys. In the case of PrEP, a majority of those experiencing this (66%) indicated that the barriers to access were so cumbersome that they decided Apretude was not right for them.

The authors wish to also thank community partners and individual advocates who helped publicize the survey. The following community partners offered their assistance: Avita Care Solutions, Community Access National Network (CANN), Georgia Equality, HealthHIV, Human Rights Campaign, International Association of Providers in AIDS Care (IAPAC), New Haven Pride Center, PlusInc, Positive Women’s Network (PWN), Positively Aware Magazine, The AIDS Institute, Vivent Health, and Yale University’s LGBTQ Resource Center. The following individual advocates helped to spread the word with this project: Guy Anthony, Wanda Brendle-Moss, Rick Guasco, Lynne Maureen Hurdle, Patrick Ingram, Kate McManus, M.D., Maria Mejia, La Kia Mondale, Kalvin Pugh, Matt Toresco, and Jennifer Vaughan. The authors also wish to express their gratitude to Perry Communications Group for their amazing work advertising both of the surveys. Lastly, this project would not be possible without the assistance of those individuals who shared the survey and those who took the time to share their perspectives.

Additional research on patient perspectives is warranted in this space. Download the final report, here.

Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association, but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about public health-related issues and updates.

Thursday, March 14, 2024

CROI 2024 Highlights: Conference on Retroviruses and Opportunistic Infections

By: Ranier Simons, ADAP Blog Guest Contributor

The fight against HIV and other viruses like HCV and SARS-CoV-2 is a worldwide team effort. That is why the Conference on Retroviruses and Opportunistic Infections (CROI) convened from March 3rd through March 6th, 2024 in Denver, Colorado. Since 1993, CROI has brought together scientists, clinical scientists, and epidemiologists to present original groundbreaking research and collaborate to advance the treatment and prevention of HIV and other viral infections and opportunistic diseases.[8] CROI is one the first places research showing the effectiveness of triple-drug therapy for HIV was shared. It was also one of the first places where the results of the SMART study were shared, which proved that early treatment of HIV provides the best outcomes.[8] This year, 4,000 attendees gathered at CROI. Participants presented a multitude of novel and emerging therapies and studies. What follows are just a few notable highlights.

CROI 2024
Photo Source: CROI

Long-Acting Injectables Blaze Forward

GSK’s long-acting injectable, cabotegravir, has already shifted the antiretroviral therapy (ART) paradigm. Coupled with rilpivirine, it is one-half of Cabenuva, the first complete ART injectable approved by the U.S. Food & Drug Administration (FDA). Cabenuva allows people who live with HIV (PLWH) to change from taking daily pills to the Cabenuva injection monthly or every two months. Studies have proven it is effective for those who have medication adherence challenges. It also presents an option for PLWH who wish to make medication management a less intrusive part of their lives.

ViiV Healthcare, the HIV-focused subsidiary of GSK, presented data from a clinical trial for a revolutionary new ultra-long-acting cabotegravir at CROI.[7] The new formulation has a higher concentration and double the half-life, potentially allowing it to be dosed every four months instead of every two.[7] Further clinical trials will be conducted to explore the use of the new formulation of cabotegravir as PrEP and as a treatment for PLWH. GSK’s goal is to have the first long-acting injectable for HIV prevention on the market by 2026 and for HIV treatment by 2027. The company also aims for an annual long-acting injectable by the first part of the 2030s.

DoxyPEP for STIs

DoxyPEP stands for doxycycline post-exposure prophylaxis. It is the practice of taking 200mg of oral doxycycline within 24 to 72 hours of condomless sex. Clinical trials have shown that DoxyPEP is effective in reducing the incidence of bacterial STIs such as syphilis and chlamydia. Results of Doxy PEP clinical studies of reducing STIs have been so promising that the CDC proposed guidelines for DoxyPEP usage in October 2022. However, those guidelines are not finalized.[1] 

Infectious disease professionals at CROI presented new data regarding DoxyPEP usage out in the real world among populations of people, mainly cisgender MSM and transgender women. Previous data was from clinical trials in contrast with new data that examined the results of DoxyPEP uptake in over 3,700 clients of sexual health clinics across San Francisco. Usage resulted in a 58% reduction in bacterial STI cases overall, a 67% reduction in chlamydia, and a 78% reduction in syphilis cases.[2] The real-world data indicated that when offered, there was a demand for DoxyPEP, and people consistently integrated it into their sexual health routine. As the Centers for Disease Control & Prevention (CDC) finalizes formal guidelines, DoxyPEP may potentially be solidified as another viable form of population wide STI prophylaxis.

Weekly Oral Antiretroviral Therapy

Long-acting injectable HIV therapy is not an optimal treatment modality for everyone. Nevertheless, other options for medication adherence that do not involve a daily regimen are needed for optimal health outcomes. At CROI, Gilead Sciences and Merck presented data from a clinical trial for a possible weekly oral antiretroviral therapy (ART) solution.

The solution is a weekly dosage of Gilead’s Sunlenca (lenacapavir), and an experimental drug named islatravir from Merck. [3,4] The phase 2 trial compared 104 patients taking daily Biktarvy (bictegravir 50mg/emtricitabine 200mg/tenofovir alafenamide 25mg tablets) with a group taking the weekly oral lenacapavir with islatravir. Data indicated that 94.2% of subjects taking the lenacapavir/islatravir combination maintained their viral suppression compared to 92.3% of the Biktarvy group.[3,4] The study will continue for another 48 weeks as open-label. This means that the study is no longer randomized. Both the medical professionals and the subjects know precisely what they are being given. There is no placebo. Studies move forward to open-label from randomized controlled studies once a high level of efficacy is proven and high benchmarks of defined endpoints are reached. 

Protecting Pregnant Women from HIV Infection

Research has shown there are physiological changes in the female body that cause a threefold increase in the risk of contracting HIV while pregnant.[5] This is especially troubling for countries where HIV is at an endemic level. Medications for HIV treatment and prevention are powerful, and it is crucial to find safe pharmaceuticals that will not harm the mother or the developing fetus.

At CROI, data from a multi-country (South Africa, Uganda, and Zimbabwe) clinical study presented safe options. A monthly flexible vaginal ring containing dapivirine as well as oral daily tenofovir disoproxil fumarate/emtricitabine PrEP (Truvada) were shown to be safe for use for pregnant women. The dapivirine vaginal ring is established in some African countries to be used as HIV prevention for cisgender women who are not pregnant. Truvada has already been proven to be safe for pregnant HIV-positive mothers to use.

The study was a randomized trial where pregnant women aged 18-40 used the dapivirine ring or received the oral PrEP up until delivery or for 41 weeks and six days, depending on which came first.[6] Only 1% experienced stillbirth or miscarriage, 95% of the women’s pregnancies went to term, and 4% of the births were premature.[6] Most importantly, none of the women contracted HIV. The results indicate that both the ring and Truvada are safe for pregnant mothers and their unborn fetuses to protect them from infection.

CROI continues to be a catalyst for pushing HIV and other infectious disease research forward. Scientific communities meet there, spurring the most qualified and passionate minds to collaborate and innovate. Whenever a cure for HIV is found, it would not be surprising if someone at a future session of CROI first presents it.

[1] DiMarco DE, Urban MA, Fine SM, et al. Doxycycline Post-Exposure Prophylaxis to Prevent Bacterial Sexually Transmitted Infections [Internet]. Baltimore (MD): Johns Hopkins University; 2023 Sep. Available from: https://www.ncbi.nlm.nih.gov/books/NBK597440/

[2] Carstens, A. (2024, March 6). DoxyPEP aces first real-world test. Retrieved from https://www.thebodypro.com/article/croi-2024-doxypep-real-world-clinical-data

[3] Clinical Trials Arena. (2024, March 7). Gilead-Merck’s combination therapy maintains HIV suppression in trial. Retrieved from https://www.clinicaltrialsarena.com/news/gilead-merck-hiv-trial/?cf-view

[4] Taylor, P. (2024, March 7). Gilead and MSD say weekly oral therapy controls HIV. Retrieved from https://pharmaphorum.com/news/gilead-and-msd-say-weekly-oral-therapy-controls-hiv

[5] Salzman, S. (2018, March 9).New study shows women's HIV risk triples during pregnancy, quadruples postpartum. Retrieved from https://www.thebodypro.com/article/new-study-shows-womens-hiv-risk-triples-during-pre

[6] HIV.gov. (2024, March 5). Vaginal ring and oral Pre-Exposure Prophylaxis found safe for HIV prevention throughout pregnancy. Retrieved from https://www.hiv.gov/blog/vaginal-ring-and-oral-pre-exposure-prophylaxis-found-safe-for-hiv-prevention-throughout-pregnancy

[7] Reuters. (2024, March 5). GSK's new HIV drug formula could support longer dosing intervals. Retrieved from https://www.reuters.com/business/healthcare-pharmaceuticals/gsks-new-hiv-drug-formula-could-support-longer-dosing-intervals-2024-03-04/

[8] CROI Foundation. (2024). General information about CROI. Retrieved from https://www.croiconference.org/about/

Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association, but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about public health-related issues and updates. 

Thursday, June 9, 2022

Ramifications of Pharmaceutical Supply Chain Challenges

By: Ranier Simons, ADAP Blog Guest Contributor

The COVID-19 pandemic has globally brought awareness to many aspects of daily life that previously remained in the shadows, discussed only by select groups of people in siloed industries and centers of knowledge. A spotlight has been shone on food insecurity, lack of infrastructure to effectively manage global public health crises, inequalities regarding social determinants of health, and supply chain issues affecting everything from housing building materials to Starbucks menu ingredients. One serious supply chain pain point is the pharmaceutical supply chain. Drug supply chain issues are more than just an inconvenience, and they can lead to grave harm or death.

The Drug Supply Chain
Photo Source: theworldcreate.net

Drug supply chain issues come in many forms: production limits, storage, and distribution problems, reduced shipping capacity, and even transportation problems.[1] These problems lead to drug price inflation, the proliferation of counterfeit drugs, the dissemination of contaminated or poorly manufactured drugs, and even extreme shortages, leaving people without needed pharmaceuticals.

Zebra Technologies Corporation conducted a study called the Pharmaceutical Supply Chain Vision, releasing the results on February 8, 2022. The company specializes in technological solutions to workflow concerns. Zebra surveyed over 3,500 patients and pharmaceutical executives to gauge perceptions of the drug supply chain in terms of its resilience, responsibility, and trust and examine ways to improve visibility and transparency.[1] 

The most important issue identified by patients regarding drug supply chain issues is the quality of the pharmaceuticals. Ninety percent desired a guarantee that their medications were not counterfeit, were stored at correct temperatures, and had not been tampered with.[1] Eighty percent of the patients desired to know the country of origin of their medications and the manufacturing standards of those countries.[1] Other significant concerns were drug affordability and shortages. Many reported that their needed medications were often out of stock, and 69% said they feared taking the improper dosage due to misleading or incorrect label information.[1] Seventy percent reported changing medications, pharmacies, or healthcare providers due to drug supply chain issues.[1]

It is of the utmost importance to keep medications safe throughout the supply chain. Patients, healthcare professionals, and pharmaceutical executives agree that transparency and traceability in the drug supply chain are potent solutions to many present problems. Technology can be leveraged to provide tracking of medication shipments, pharmaceutical production workflow from raw material to final product, and even improvements in the ways drugs are produced. 

The only way to improve the status quo is a group concerted effort to report and gather the data. This sort of data needs to be in publicly accessible databases. These databases would bolster consumer confidence as well as enforce accountability for those along the supply chain. The National Academies of Sciences, Engineering, and Medicine (NASEM) recommends that “the FDA make sourcing, quality, volume, and capacity information publicly available for all medical products approved or cleared for sale in the U.S.”[2] 

This sort of information would make it possible to monitor weaknesses in the supply chain and address them. It would also enable predictions of shortages. Moreover, just like credit bureaus, third-party companies could use the data to create rating systems. Rating systems would enable healthcare systems and other large purchasers to make informed decisions to purchase the best possible medications for their populations. This would also create competition among manufacturers giving the incentive to create the best environment for producing and transporting high-quality medicines to patients.[2] There are legal regulatory hurdles to be overcome for such a public repository of information, but it is a very practical solution.

Drug Supply Chain flow chart
Photo Source: Association for Accessible Medicines

During the pandemic, people living with HIV have been especially concerned about drug shortages for their life-saving antiretroviral medications. In 2020, the ADAP Advocacy Association took action to address those concerns. It contacted antiretroviral drug manufacturers directly to inquire about what steps they were taking to secure the supply.[3] 

The ADAP Advocacy Association contacted AbbVie, Jansen Pharmaceuticals, Gilead Sciences, Merck, Theratechnologies, and ViiV Healthcare, all manufacturers of HIV antiretrovirals. Discussions with the companies resulted in the optimistic projection of no foreseen disruption in their drug supply chain. Brandon M. Macsata, CEO of the ADAP Advocacy Association, stated that “their combined assurances provided significant peace of mind for the people living with HIV/AIDS who we represent, and who rely on these life-saving medications.” 

Continuing to innovate to improve the drug supply chain is not just good for manufacturers' bottom line. It also means improved quality of life and lowered mortality for the global population.

[1] Beusekom, M. (2022, February 24) Patients, pharma execs express low trust in drug supply chains. Retrieved from https://www.cidrap.umn.edu/news-perspective/2022/02/patients-pharma-execs-express-low-trust-drug-supply-chains
[2] Frieden, J. (2022, March 4). How can the U.S. preserve its medical supply chain? Retrieved from https://www.medpagetoday.com/publichealthpolicy/healthpolicy/97524
[3] 
Macsata, B. (2020, April 24). Nation's HIV drug supply secure despite coronavirus pandemic. Retrieved from https://adapadvocacyassociation.blogspot.com/2020/03/nations-hiv-drug-supply-secure-despite.html

Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association, but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about public health-related issues and updates.  

Thursday, March 26, 2020

Nation's HIV Drug Supply Secure Despite Coronavirus Pandemic

By: Brandon M. Macsata, CEO, ADAP Advocacy Association

****UPDATED APRIL 24, 2020 - 5:22 P.M. EST*****

The ADAP Advocacy Association has fielded countless inquiries from people living with HIV/AIDS expressing concerns over the novel Coronavirus ("COVID-19") and its impact on the nation's drug supply chain. Namely, their concerns have centered around potential drug shortages of the anti-retroviral medications for the treatment of HIV/AIDS. No such drug shortages are foreseen for these medications over the coming year, thanks to the assurances extended by the drug manufacturers AbbVie, Janssen Pharmaceuticals, Gilead Sciences, Merck. Theratechnologies, and ViiV Healthcare.

Drug Supply
Photo Source: master control.com

The ADAP Advocacy Association contacted each company about the patient community concerns, and the respective drug manufacturers provided the following statements.
  • ABBVIE STATEMENT:
"AbbVie is closely monitoring product demand and supply levels throughout our global network to ensure adequate and effective distribution. While helping respond to the COVID-19 crisis is a high priority, AbbVie is committed to protecting the supply of Kaletra/Aluvia for HIV patients. AbbVie is actively assessing the increased demand for Kaletra/Aluvia and has taken steps to increase supply for COVID-19 patients without impacting treatment supply for HIV patients. Our priority is to ensure uninterrupted supply for HIV patients around the world."

Read the AbbVie statement online.
  • GILEAD SCIENCES STATEMENT:
"Over the last several weeks, we know you have heard from many of your constituents who are concerned the novel coronavirus pandemic could impact their ability to obtain HIV medication. We wanted to reach out to assure you there are currently no manufacturing concerns or supply shortages with any Gilead products, including our HIV portfolio.

Gilead’s global commercial supply chain is robust and resilient with the right processes in place, geographic diversity in our supply chain and enough of the materials required to make our medicines. We have done this purposefully and carefully to enable continued supply of Gilead’s medicines in a challenging situation like the one we face today. As a result, we are not seeing, and we do not anticipate, shortages of Gilead marketed products, including our HIV medicines, in the foreseeable future.

Our supply network provides both flexibility and redundancy, and our inventory levels are robust, with no immediate or foreseeable risk to our supply chain. For more information, please see this article on Gilead.com. We are also working closely with our partners to monitor travel restrictions and border closings. There are currently no restrictions or delays limiting the transport of goods, including medications.

Some wholesalers have proactively implemented allocation limits on several pharmaceutical products, including HIV medications. In the event that pharmacies experience a temporary lack of inventory, they should contact their wholesaler to request an exception to these limits. When necessary and approved by the wholesaler, Gilead is able to drop-ship directly to a pharmacy. A complete list of authorized distributors can be found here.

Additionally, while we have paused enrollment for some clinical studies, we have made important exceptions for studies where patient outcomes are critically impacted. This includes studies of our investigational HIV capsid inhibitor GS-6207 in people who have multi-drug resistant HIV and therefore have limited treatment options. We will also continue to prepare for new study initiations in the face of temporary delays to most study enrollments.

During this uncertain time, it is more important than ever that we stay in close communication. We do not see any potential disruption to our supply chain now or in the foreseeable future. Gilead is committed to ensuring you have up-to-date information on our efforts to help the HIV community respond to the novel coronavirus pandemic and will keep you apprised of any changes."

Read the Gilead Sciences statement online.
  • JANSSEN PHARMACEUTICALS STATEMENT:
"In our role as a global health leader, Johnson & Johnson is closely monitoring the COVID-19 (coronavirus) situation and taking steps to help prevent the spread of the virus as well as exploring the potential for a vaccine.

We have robust business continuity plans in place across our global supply chain network to prepare for unforeseen events and to meet the needs of the patients, customers and consumers who depend on our products.  These steps include maintaining critical inventory at major distribution centers away from high-risk areas and working with external suppliers to support our preparedness plans.

We are closely monitoring product demand and supply levels across our global network to ensure adequate and effective distribution, and working diligently to meet patient, customer and consumer need.

Below is a summary by sector:

​​​​​​​- Pharmaceutical: While this remains a dynamic situation, we do not foresee pharmaceutical supply interruptions related to COVID-19 at this time.

- Medical Devices: While this remains a dynamic situation, the vast majority of our global medical device manufacturing is running at or near normal capacity, and we are not experiencing product supply interruptions at this time.

- Consumer: We are experiencing increased consumer-driven demand with certain products and markets, which we are currently meeting in a controlled manner. We are taking all possible measures to maximize product availability.

As a leader in global health, our top priority remains our patients, customers and employees. We are partnering with global and local health authorities to address immediate and long-term health care needs, to ensure sustainable supply of our critical medicines, as well as to research potential vaccines and therapeutics.

We will remain on the front lines of this health crisis, bringing our full resources and minds to combat it."
  • MERCK STATEMENT:
"We continue to track the COVID-19 outbreak closely and are focused on the safety of our employees and their families, continuity of supply and clinical trials, and supporting communities affected by this outbreak. Our thoughts are with the people of all affected areas. We would also like to extend our sincere appreciation to the many health care providers and volunteers who are doing so much to help affected patients and communities.

While supply and demand vary by product, we are not aware of any significant near-term impacts from COVID-19 on the production and supply of Merck's medicines and vaccines.  We have also assessed potential longer-term impacts of the outbreak. The situation is fluid, but at this point we do not anticipate impacts to our supply chain unless the outbreak were to continue for an extended period of time."

Read the full Merck statement online.

Read the supplemental Merck statement online.
  • THERATECHNOLOGIES STATEMENT:
"At Theratechnologies, we presently have enough inventory, here in the U.S., for our 3 products and expect to be able to provide Trogarzo®, EGRIFTA SV™ or EGRIFTA® to all currently prescribed and new patients during the next 12 months. In addition, the production for all of our products is not affected at this stage by the COVID19 situation."
  • ViiV HEALTHCARE STATEMENT:
"In these uncertain times, the safety and well-being of our employees, customers, partners, and people living with HIV remains ViiV Healthcare’s top priority. As the coronavirus (COVID-19) continues to affect communities in the US and around the world, our hearts go out to those impacted, and we want to share our response to the evolving situation.

We have been closely monitoring the COVID-19 pandemic and its impact. We believe it is our responsibility to prioritize two things:

- our commitment to supporting the health and safety of our employees, customers, partners, and people living with HIV;

- protecting our ability to manufacture and supply medicines

Consistent with our values and role as the only global healthcare company solely focused on HIV, we will continue to make decisions informed by the latest science and in consultation with leading health authorities.

In-line with these principles, we have implemented a variety of measures to help prevent spread of disease and minimize disruption to our operations.

- Ensuring medicine supply and patient access. At this time, even with loosened restrictions on early and various quantity refills by US government and private payers, there is no impact to supply of our medicines in the US as a result of the COVID-19 pandemic. We are continuing to closely monitor the situation and will keep you updated on any changes. We have supply chain planning in place for our products, which includes measures to secure reliable supply, such as holding strategic stock as well as working with our wholesalers, pharmacies and direct purchasers to ensure they are responding to the demand for our medicines from providers and people living with HIV.

- Caring for our people and communities. We have taken several temporary measures to protect the well-being of our employees and the communities in which we operate. We have directed our field teams to suspend all face-to-face interactions and refrain from visits to clinical offices, healthcare centers and other customer offices. Virtual interactions will be implemented to ensure we continue to provide support and ensure adequate supply and access to resources and our medicines.

- Contributing to the fight against COVID-19. We are conducting some exploratory research to see if our medicines may have the potential to demonstrate impact, although it is too early to speculate on any benefit. We are pleased that our major shareholder, GSK, is contributing its science and expertise where they can have most impact on the outbreak. They recently announced a research collaboration with Clover Biopharmaceuticals, providing their pandemic vaccine adjuvant technology to scientists at Clover who will use their cutting-edge research to evaluate the combination of GSK’s adjuvant with its promising vaccine candidate, S-Trimer.

Patient focus is one of our core values and we are proud of our employees and their commitment to people living with HIV during these challenging times.

The situation is changing rapidly, and we are closely monitoring this as we seek to safeguard the health and well-being of our employees, limit the spread of the disease, and continue to make our products available to all who need them. We will continue our vigilance in assessing the situation."

Read the ViiV Healthcare statement online.

The U.S. Food & Drug Administration (“FDA”) has made available information on the current drug shortages online at https://www.fda.gov/drugs/drug-safety-and-availability/drug-shortages.

Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association, but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about public health-related issues and updates.

Thursday, January 12, 2017

10 Years of Accomplishment, Advocacy & Access to Care

By: Brandon M. Macsata, CEO, ADAP Advocacy Association

It is hard to believe it is true, but 2017 marks the 10-year anniversary for the ADAP Advocacy Association. What started out as an idea by our founder and co-chair, William "Bill" Arnold, and a small start-up grant from Ramsell Corporation, has bloomed into a national voice for people living with HIV/AIDS who rely on the AIDS Drug Assistance Program (ADAP). Throughout these ten years one thing has remained true, that the voice of people living with HIV/AIDS shall always be at the table and the center of the discussion.

One of our greatest accomplishments was launching the ADAP Directory, which was initially made possible by generous grants from AbbVie, Merck, and Walgreens. The groundbreaking approach provides a one-stop online resource center for the latest ADAP information for better decision-making for HIV/AIDS care, improved quality of HIV/AIDS information, and assistance for advocates and care providers. In 2016, over 21,000 users visited the ADAP Directory. Additionally, last year we added the "ADAP Eligibility Calculator" as a new user-friendly, patient-centric tool — powered by Pill Pack — designed to provide additional information about possible ADAP eligibility.

The ADAP Directory

Years earlier during the ADAP waiting list crisis, we hosted an Emergency ADAP Summit in Fort Lauderdale just as the Florida ADAP was on the verge of kicking nearly 3,000 patients off of the program. The event embodied activism in motion because patients were speaking out against the growing waiting lists. Behind the scenes the former President & CEO of the Heinz Family Philanthropies, Jeffrey Lewis, was bringing together the necessary players to launch the Welvista Solution — which provided life-saving medications to literally thousands of people living with HIV/AIDS on ADAP waiting lists. We were honored to have played a role in making it happen.

Advocates protesting ADAP waiting lists.

That same year, we released Public Service Announcements on ADAPs to raise awareness about ongoing the ADAP waiting list crisis. The 60-second PSA aired over six weeks from February 21, 2011, to April 3, 2011, over 210 media outlets nationwide. The PSAs were produced by Neil Romano of The Romano Group, LLC – who worked on campaigns such as "Just Say No" and "America Responds to AIDS."

Public Service Announcement on ADAP showing patient with the words, "teammate & friend."

2017 is a new year, and with it will undoubtedly come new challenges. There remains much uncertainty over the incoming Trump Administration and its implications for the Affordable Care Act and the Ryan White CARE Act. For now, we are continuing to focus on what has been our stable approach to advocacy: the patients voice! Our 10th Annual Conference — which is slated for September 22-23, 2017 in Washington, DC — is being themed, "Unchartered Water: AIDS Drug Assistance Programs in the Age of Trump." In addition, possible collaborative projects are being planned with the AIDS Healthcare Foundation (AHF), Community Access National Network (CANN), HealthHIV and the Professional Association of Social Workers in HIV & AIDS (PASWHA).

This year, two special education projects are planned to improve access to care among transgender men and women living with HIV/AIDS, as well as linkages to care for incarcerated (and formerly incarcerated) populations. As in years past our Scholarship Fund will ensure that the patients voice remains front and center, and this objective couldn't be achieved without the fund's two chief funders, CANN and Housing Works, as well as the many other supporters.

Access to care has been at the center of our mission, and it will continue to do so. Adherence is key to HIV treatment working, thus promoting a robust AIDS Drug Assistance Program is vital to combatting the disease and ending the epidemic. Though our focus is almost exclusively on ADAPs, we will continue to work with advocates, community, health care, government, patients, pharmaceutical companies, and other stakeholders to raise awareness, offer patient educational program, and foster greater community collaboration.

In closing, we would like to thank our funders because our 10th anniversary couldn't happen without their past and ongoing support. Since 2007, our funders have included: Abbott Laboratories, AbbVie, AIDS Alabama, AIDS Drugs Online, AIDS Healthcare Foundation, Alibi Wilton Manors, American Association for Homecare, Audio Visuals & Computer Services, Bender Consulting Services, Biotechnology Industry Organization, Bristol-Myers Squibb, Broward House, Community (A Walgreens Pharmacy), Community Access National Network, Dab the AIDS Bear Project, DC's Most Fabulous Magazine, Diplomat Specialty Pharmacy, Duane Reade Pharmacy (A Walgreens Pharmacy), EHiM, EMD Serono, Elwyn Specialty Care, Flowers Heritage Foundation, Forthright Strategies, HealthHIV, HMS, Housing Works, Genetech, GettingHired.com, Gilead Sciences, Great Lakes ADA Center, Janssen Therapeutics, Job Accommodation Network, Justin's Cafe, Kellari, Kimptons Hotels & Restaurants, Macsata-Kornegay Group, MedData Services, Merck, MOMS Pharmacy, Morgali Films, Mylan Pharmaceuticals, Napo Pharmaceuticals, Number 9, O.B. Sweet, OraSure Technologies, Patient Access Network Foundation, Patient Advocate Foundation, Pharmaceutical Research and Manufacturers of America, Philadelphia FIGHT, Pill Pack, Public Sector Solutions, Ramsell Corporation, The AIDS Institute, Theratechnologies, Social Security Administration's Ticket-to-Work, Southern AIDS Coalition, Southwest Airlines, Starbucks, SunTrust Bank, Turing Pharmaceuticals, Vertex Pharmaceuticals, ViiV Healthcare, Walgreens, We Movement, Wells Fargo, Women's Institute For A Secure Retirement, and World AIDS Institute.

But most of all, we would like to thank the thousands of individual supporters who joined our organization, attended our educational events, and/or donated to us. We couldn't have reached 10 years without you!


Friday, September 16, 2016

Annual National Monitoring Report on HIV/HCV Co-Infection

By: Marcus J. Hopkins, Project Director, HIV/HCV Co-Infection Watch, Community Access National Network (CANN)

The ADAP Advocacy Association is sponsoring an important community roundtable on September 22nd in Washington, DC, hosted by the Community Access National Network (CANN). The pressing issue at hand: HIV/HCV Co-Infection. The First Annual National Monitoring Report on HIV/HCV Co-Infection will present findings on the state of human immunodeficiency virus (HIV) and hepatitis C (HCV) co-infection in the United States, including a summary of the HIV/HCV Co-Infection Watch, as well as the HealthHIV/HealthHCV recently published report, State of HCV Care National Survey.

The event will be held at the Pharmaceutical Research and Manufacturers of America (PhRMA) Headquarters, located at 950 F St., NW Suite 300, Washington, DC 20004. It will be held from 3:00 PM – 5:00 PM (EST). Gilead, Merck and Walgreens are also sponsoring this event, along with PhRMA.

While both HIV and HCV are significant health issues on their own, co-infection poses a serious threat to persons living with HIV. Treating HCV in conjunction with HIV can be difficult, as many of the most popular HIV combination therapies (such as Stribild) may have serious drug interactions with some of the components of newer Direct Acting Agents (DAAs) currently available to cure HCV.

Recent spikes in HCV infections related to Injection Drug Use (IDU) have led physicians in affected areas to screen also for HIV. Perhaps the most well-publicized case involved an outbreak in Scott County, Indiana, was caught due to a sharp increase in HCV infections amongst IDUs. The outbreak also led the state’s conservative legislature to approve emergency Harm Reduction measures – namely Syringe Exchanges – in counties designated as having public health emergencies. The sixth such emergency Syringe Exchange will be opening in Clark County, this fall. Clark County, which neighbors Scott County, has seen a 63% increase in fatal drug overdoses since 2013, with 49 confirmed fatal overdoses, and another 20 pending since the beginning of the year (Maher, 2016).

The HIV/HCVCo-Infection Watch released its inaugural Report in January 2015, originally focusing only on HCV drug coverage in AIDS Drug Assistance Programs (ADAPs) and Medicaid programs. Now, nearing the end of its second year in publication, the Watch has expanded to include coverage information for the Veteran’s Affairs (VA), Harm Reduction measures (including Syringe Exchanges) to prevent the spread of infection, and regional trends, which focus on issues of drug coverage, co-infection, and legislative efforts to combat the spread of HCV. Each Report also contains the latest news in HCV science, opioid/heroin addiction, pharmaceutical updates, and HIV/HCV-related news.

HIV/HCV Co-Infection Watch

 HealthHIV’s report on the State of Hepatitis C Care National Survey was released in February 2016, and presents the findings gathered during the survey process. The inaugural survey, conducted in 2015 in conjunction with Medscape, LLC., collected data on both providers and the patient populations they serve, and made policy recommendations and observations related to increasing access to HCV care both outside and within the HIV care continuum.

HealthHCV HCV Care Survey

 While the National Monitoring Report on HIV/HCV Co-Infection event is free to attend, seating is limited. Advanced registration is required, which can be done at the following web address: https://www.123signup.com/event?id=njrck.

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Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association, but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about public health-related issues and updates.

Thursday, April 7, 2016

ADAP Directory & ADAP Formulary Database Link Stakeholders to Important Tools

By: Brandon M. Macsata, CEO, ADAP Advocacy Association

On March 15th (2016), an important resource was once again made available by the National Alliance of State & Territorial AIDS Directors (NASTAD). NASTAD released its 2016 Online AIDS Drug Assistance Program (ADAP) Formulary Database and accompanying User’s Guide. The Database complements the patient-centric ADAP Directory, which is the ADAP Advocacy Association's flagship program.

NASTAD describes the provider-focused Database as "an online, searchable, publicly available resource detailing state-by-state ADAP coverage of medications both individually and by drug class including HIV antiretroviral (ARV) treatments, “A1” Opportunistic Infections (A1 OI) medications, treatments for hepatitis B and C, mental health and substance use treatment medications, and various vaccines and laboratory tests."[1]

Key findings from the 2016 ADAP Formulary Database include:[2]
  • 3 ADAPs have “open formularies” in which all FDA-approved medications are included, excluding designated exceptions
  • 38 ADAPs cover one or more hepatitis B treatment medication
  • 33 ADAPs cover one or more hepatitis C treatment medication
  • 19 ADAPs cover one or more of the curative direct acting antiviral (DAA) hepatitis C (HCV) treatment medications
  • 9 cover daclatasvir (Daklinza)
  • 17 cover dasabuvir, ombitasvir/paritaprevir/ritonavir (Viekira Pak)
  • 19 cover ledipasvir and sofosbuvir (Harvoni)
  • 8 cover ombitasvir, paritaprevir and ritonavir (Technivie)
  • 12 cover simeprevir (Olysio)
  • 17 cover sofosbuvir (Sovaldi)
  • 43 ADAPs cover one or more of the most frequently prescribed mental health treatment medications
  • 14 ADAPs cover one or more substance use treatment medication 
The ADAP Directory – launched in 2014 with ongoing support from AbbVie, Gilead Sciences, Janssen Therapeutics, Merck, ViiV Healthcare, and Walgreens – ensures that people living with HIV-infection have access to the information and resources they need to live healthy and productive lives. The ADAP Directory consolidates useful ADAP-related information from all 50 states and 6 territories into one convenient location for:

  • easy access to ADAP resources organized by state and territory;
  • updated, current information for all 56 state ADAPs -- including drug formularies; and
  • uniform presentation of ADAP information for effective advocacy and easy dissemination.
The “Perfect Storm” that had ravaged the cash-strapped ADAPs between 2008-2010 exposed some very real deficiencies in the amount and quality of information made readily available to patients living with HIV/AIDS. Today, patients...and in fact, all community stakeholders...have much more user-friendly information at their disposal.

Aside from the interactive map, which allows users to navigate all 56 ADAPs, other important resources and tools are available at the ADAP Directory. Among them, patient medication assistance programs and pharmaceutical patient assistance programs.

Chart displaying various patient assistance programs.

Chart displaying pharmaceutical patient assistance programs.

To learn more about the ADAP Directory, visit http://adap.directory. To learn more about the NASTAD Formulary Database, visit https://www.nastad.org/sites/default/files/2016-ADAP-Formulary-Database-Users-Guide.pdf.
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[1] National Alliance of State & Territorial AIDS Directors (NASTAD), "Update: 2016 ADAP Formulary Database," March 16, 2016.
[2] National Alliance of State & Territorial AIDS Directors (NASTAD), "Update: 2016 ADAP Formulary Database," March 16, 2016.