How do you set up a PrEP Clinic?
Making this life-changing medication available to greater numbers of people requires having access to the necessary
testing and medication. Our goal is to put the medicine and the information for its use in the hands of as many
people as possible all over the world. Our primary work is in the U.S. where the specific limitations of the health care system
may place barriers to preventative care. The following steps are meant to help other clinicians in the U.S. establish PrEP
clinics in their communities.
Family Health Care is planning to establish a blog to share information about successes
and lessons learned about PrEP experiences. Check here later if you are a clinician or administrator interested in making
PrEP more available.
Step 2- Decide how you want the PrEP patient to interact in your practice.
A. If you are growing your practice, you may want to offer PrEP as a means of introducing your practice to new patients.
B. If your practice is closed (due to volume or by policy- for example if your practice is by charter restricted
to people who are infected with HIV), you may want to restrict the services for PrEP patients. (Please note, this may require
specific wording for patient registration in order to segregate PrEP patients and protect your practice.)
If the scope of services is to be limited:
· Providers must keep in mind that providing medical consultation to a patient
may constitute the initiation of a patient-provider relationship.
· Generally the relationship between a health care provider and a patient is legally
and ethically defined broadly to include an on-going “Duty of Care” that covers a broad definition of medical
services, often limited by the physician’s specialty.
In order to be clear that the scope of the medical
consultations provided during PrEP Care visits are limited, consider having the patient sign an acknowledgment (perhaps on
the intake registration form*) of the restricted nature of the relationship and that there is no intent to enter into a broad
doctor-patient relationship. This is to be clear that the consultant will not assume additional care responsibilities.
It may also be useful to require
that a patient list a primary provider and indicate if records should be sent to that provider.
jurisdiction is different and it is recommended that you obtain appropriate legal review of intake and consent forms.
Step 3- Learn about testing and treatment costs for uninsured patients in your community.
In our experience many of those who are at risk for HIV and may benefit from prophylaxis are uninsured. There may
be assistance for the required screening tests in your community. Gilead, the manufacturer of Truvada, offers patient assistance
for the uninsured. There are also co-pay cards available for those whose insurance has high medication co-payments. (See below.)
Gilead U.S. Advancing Access® Program
This program provides
assistance to patients in the United States who do not have insurance or who need financial assistance. As part of this program,
Gilead provides assistance for people who are eligible and who cannot afford to pay for TRUVADA. To learn about eligibility,
contact Advancing Access® at 1-800-226-2056 between 9:00 a.m. and 8:00 p.m. (Eastern). You can also download the enrollment form to be completed by you and your healthcare provider.
Partnership for Prescription
Assistance (PPA) Program
This program is designed to help uninsured Americans get the prescription medicines
they need at no or low cost. To find out if you qualify, here’s what to do:
- Call toll-free 1-888-4PPA-NOW (1-888-477-2669).
- Know the names of the medicines you
- A trained specialist will answer your questions and help you apply.