Bedaquiline for Insured Patients

Provider contacts the patient’s insurance to inquire if Bedaquiline is in their formulary.

If yes, ask for a letter stating that they’ll cover the patient’s medications, and how much will the cover and how much will the patient copy amount will be.
There is help with commercial insurance patient’s copay. The patient must be on the phone with the provider to call Jensen at 855-846-5392 who will interview the patient and most likely approve the co-pay assistance.

On the fax prescription to Metro Medical include the information provided by Jensen and the patient’s insurance information.
Always follow up with a phone call to Metro the day after you fax the prescription to make sure that they have all the information they need.
Another option is for the health department to purchase the medication at 340B pricing ( ~ $23,000.00) and bill the insurance company.

Above are suggestions but this does not substitute health department internal procedures.

Amy R. Painter, BSN, RN
TB Division Director
S.C. Dept. of Health & Environmental Control
Mobile: (803) 722-0179

Office: (803) 898-0644

Fax: (803) 898-0685
Connect: www.scdhec.gov Facebook Twitter

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Hello fabulous TB nurses 😊

I’m 99.9% sure I’ve seen this question before pop up, but it has been a minute and I’ve slept a little since then. We are needing to obtain Bedaquiline for a patient of ours and we’ve never had to acquire this medication before. My colleague had referenced the link on NTCA’s page, but our patient would not qualify for any assistance IF solely income based. Has anyone dealt with a insurance covering this medication? Any advice or experience anyone has had with obtaining this medication would be so greatly appreciated. This is a whole new situation for us here in Arkansas.

Hope you all have a wonderful Friday/weekend!

Thank you!

Jenna Maturino BSN, RN

Arkansas Department of Health – Infectious Disease

TB Program Nurse Consultant

4815 W Markham Street, Slot #45

Little Rock, AR, 72205

Office: 501-661-2068 |Cell: 501-940-0682

Fax: 501-661-2226

Email: Virginia.Maturino@arkansas.gov

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