Table 4 System level implementation barriers to LA ART and proposed solutions

Cost - equivalency to oral ART

“Possible high costs.” (Argentinian provider)

“Cost constraints, and accurate cost projections.” (U.S. provider)

“Cost of drug to physicians for purchasing for the office” (U.S. provider)

Competitive cost with oral ART

“Pricing must be equivalent to standard therapy.” (German provider)

“Provision of LA regimen free to the public sector” (South African provider)

“Reduce the cost of drugs for countries with a generalized HIV epidemic. “(Russian provider)

Cost - mechanisms of reimbursement

“Reimbursement for the medication.” (German provider)

“Potentially the overall cost for insurance carriers (i.e. doctor visits + injections + medication cost).” (U.S. provider)

“Insurance issues, insurance reimbursement for clinic injection visits.” (U.S. provider)

Government-subsidized treatment

“Having adequate approvals with ADAP, Medicare, and commercial insurances.” (U.S. provider)

Co-pay assistance

“Copay cards or assistance for patients with and without insurance” (U.S. provider)

Clear compensation guidelines for clinics

“Clear guidelines regarding compensation for the increased number of visits that injection treatment generates, we would end up with our order and not receive reimbursement for our costs - in short, the economy controls and in this case the staff cost.” (Swedish provider)