July was our first month of pharmacy operations at the Rod Bragg Music City PrEP Clinic and the results are in–the costs are outrageous and the results are worth it.
Up until now, we have been s-l-o-w-l-y growing our patient base because each patient visit has associated expenses such as lab fees. We don’t ask our patients to pay for their labs and we don’t even collect a fee for the office visit. Each visits costs over $100 in labs and materials, and the volunteer staff time is donated. Having the ability to fill prescriptions through our own pharmacy (actually, we “outsource” to our pharmacy partner), we’re able to generate revenue from the prescriptions to pay for the labs and other expenses.
In July, we were able to put about half of our 20+ founding patients on PrEP. The price of the drug is outrageous–over $20,000 total for just one month. After insurance and Medicare payments, there was a gap of about $6,200. Through the efforts of the teams at the clinic and the pharmacy, we were able to completely fill that gap. That means all 12 patients received the drug with ZERO out of pocket costs!
How does this work? We’re essentially co-op’ing our patients’ insurance benefits. Some of our patients have great insurance, others not so much, and the still others have none at all. But because all of our patients #FillWithUs, we’re able to share the wealth, so to speak, by taking our pharmacy profits and subsidizing patients with financial need.
Let’s take a look at some specific examples. One of our patients thought he had great brand-name insurance. It seemed to provide excellent coverage for other medications, but when it came to paying for PrEP, he was shocked to find out that it only paid $16 of out the $1600 needed! He #FilledWithUs, helped us take care of others without insurance, and we took care of him. Zero out-of-pocket costs. He’s a hero.
In another case, a patient was already on PrEP through his primary care provider and filling through another pharmacy. He had great insurance and only had a $20 co-pay for the drug. But he chose to #FillWithUs, allowing us to redistribute the drug profits to the rest of our patients. He’s a hero. Plus, he didn’t even have to pay that $20 co-pay.
Finally, there’s the case of an immigrant patient with no insurance. Because of his immigrant status, there was extra red tape in applying for payment assistance such as supplying a copy his lease as proof of address! We helped him cut through the red tape. Because he chose to #FillWithUs, the monies we received from the drug manufacturer were redistributed to the rest of our patients. What?! It’s true. Even a patient with no insurance is able to #BeAHero.
The Bottom Line. If you Fill With Us, you help us help our community. If you already have a primary care provider prescribing you PrEP, you can keep that relationship, but Fill With Us. We’ll be your sexual health go-to and keep you healthy with free and confidential HIV/STD/STI screens every 3 months and as needed.
A side-note on those free STD/STI screens. After one of our clinics, we discovered that 75% of the patients tested positively for an STI. Most of them didn’t even know they had anything because they were asymptomatic. But because they came in for their routine PrEP visit, we were able to get them alerted and treated. In the coming months, look for a spike in Nashville STI infection rates as we continue to discover under-tested patients in our mission to eliminate HIV and improve the sexual wellness of our community.