Safety Net

Treatment Horizons by Chael Needle

A nonprofit creates a new support system for the uninsured

Joining Merck and ViiV Healthcare, Gilead Sciences is now supporting and participating in a new patient assistance program (PAP) that provides individuals living with HIV/AIDS and in treatment with a singular portal to free medications. Launched in the summer of 2012, the Columbia, South Carolina-based nonprofit HarborPath is a cooperative effort supported by the Clinton Health Access Initiative (CHAI), National Alliance of State and Territorial AIDS Directors (NASTAD), pharmaceutical companies and patient groups. It is piloting its program through partnerships with clinics in Alabama, Georgia, Florida, South Carolina, Texas, Washington, and Washington, D.C. Those who do not live in these areas or go to a participating clinic may still be eligible for PAPs.

Patient assistance programs are nothing new—pharmaceutical companies, for example, have long offered a way for those in need to apply for free or discounted medications. But as any individual in treatment knows, a regimen might be assembled from different drugs from different companies. And if you are in need of assistance, this means different applications and a potentially tedious and time-consuming process, like shopping for one meal at three different markets scattered across town. With this new portal, healthcare professionals, case managers, and patients can apply through one application rather than many and potentially improve health outcomes.

At the time of HarborPath’s launch, the federal government also announced a common application process for HIV patient assistance through a public-private partnership between the Department of Health and Human Services’ Health Resources and Services Administration (HRSA) and patient assistance programs offered by Abbott Laboratories, Boehringer Ingelheim, Bristol-Myers Squibb, Gilead Sciences, Johnson & Johnson, Merck, and ViiV Healthcare.

HarborPath builds on this platform by offering one Web-based portal for application and medication fulfillment and its own unique support to help individuals who qualify to access free HIV/AIDS-related medications. This support includes a mail-order pharmacy, including up-to-the-minute status reports on applications under review and drug delivery dates; live support for case managers; and refill reminders. HarborPath offers “best practices” strategies for promoting adherence, too.

The nonprofit plans on extending its services by bringing all the needed pharmaceutical companies on board.

HarborPath “offers case managers a much better way to navigate through the maze of PAPs,” says Ken Trogdon, Jr., president of the nonprofit, about the streamlining of an application process, which is continually ongoing. “And if you are dealing with a number of issues, trying to maintain those and remember what your time frame is in terms of reapplying can be challenging on any level. HarborPath works with clinics and case managers to actually input the patient information and apply through the portal.”

Trogdon says that they have been happy with the results so far with the pilot program, which targeted those states “where the highest number of potentially new cases were being reported, and where potentially the lack of access to medications was more challenging.”

He continues: “What we found is that it’s those clinics that have a high percentage of uninsured that are probably seeing the real value of HarborPath.” It may be especially vital for those patients who have relied on PAPs as their only safety net, and those who could qualify for PAPs but do not make use of them. “We hope that by creating this safety net that folks will be more compliant with their medications. Having that case manager as a gatekeeper is critical because those patients have to come back in every thirty days and that allows them to hopefully maintain some level of continuity.”

Trogdon tells A&U that the non-profit is continually fine-tuning its adherence strategies and support, and learning more about the challenges that patients, especially those who are underinsured and uninsured, face when staying on meds. HarborPath learns about patient needs from working closely with clinics, such as the 1917 Clinic at the University of Alabama at Birmingham. “Having spent time there and seeing the profile of who we are serving and the challenges, you really do understand why programs like ours can make such an impact in the life of the patient,” notes Trogdon.

Another key to adherence is timing and HarborPath speeds up the process. “With a PAP it can take anywhere from two to six weeks before a patient receives their drugs. With us, when a patient is approved, that drug ships within forty-eight hours. So that patient has their drugs very rapidly. There’s not a lag time there, which, obviously, from a patient and case manager standpoint, makes it very attractive.”
HarborPath’s pilot program ends this summer and it has plans to expand into additional states in August or September. It recently received $250,000 in grant money from the Elton John AIDS Foundation to help with this expansion.

The nonprofit is also planning to offer the same services for those living with hep C (both those mono-infected and co-infected with HIV) and in need of treatment. Says Trogdon: “For the continuum of this infectious disease area we’ll be a one-stop shop, providing a safety net for these folks.”

For more information, visit

Chael Needle wrote about the federal budget’s effect of HIV/AIDS healthcare in the May issue.