The Infectious Diseases Society of America, HIV Medicine Association and the Pediatric Infectious Diseases Society stand by our statement applauding Express Scripts and Imprimis for responding to patient and provider barriers accessing pyrimethamine for the treatment of toxoplasmosis due to its prohibitive cost. We are not recommending any particular medication or pharmacy. However, given the serious challenges that our members have faced accessing pyrimethamine for their patients, it is important for them to be aware of treatment alternatives, including compounded medications from companies that offer this as an alternative. Compounded products are not subject to approval by the U.S. Food and Drug Administration, but may be appropriate for individual patient use. As with treating any condition, providers will need to evaluate the most appropriate treatment option on a case-by-case basis in consultation with their patients. More information on pharmaceutical compounding is available from the American Pharmacists Association.
In order to assist members with obtaining information on alternative treatments, the following information is being provided. We will update this information as appropriate.
Availability of Compounded TreatmentExpress Scripts and Imprimis have announced the availability of a compounded formulation to treat toxoplasmosis. To order for patients – providers can complete the Imprimis Cares order form and fax to (949) 551-1950.* The form can be used for patients regardless of their care setting (e.g., inpatients or outpatients). Click here to download the Imprimis Cares Order Form Providers may prescribe for two different dosages (loading and maintenance) but they will be processed as separate prescriptions and patients will be subject to two co-payments. Imprimis can fill prescriptions written for 90 days if the patient’s Express Scripts plan does not have 30-day quantity limits.Orders are generally delivered within 72 hours, including processing and shipping. Processing may be delayed if information is missing from the prescription, such as date of birth or allergies. If not included, Imprimis will need to verify the information with the physician before processing.Daraprim also will continue to be an option for patients covered by Express Scripts, but patients will be responsible for the associated cost sharingToll-free AssistanceThe Imprimis toll-free pharmacy number is (866) 551-7195 and is staffed from 12 noon to 8 pm ET (9 am to 5 pm PT) Monday to Friday. The customer service department can be reached at (858) 704-4644 and is staffed from 9 am to 9 pm ET (6 am to 6 pm) Monday to Friday.*Note: Imprimis will accept any legal prescription written/faxed, e-prescribed or walked in. The prescription must be written for one of the strength combinations on the form.
Pediatric CasesPlease refer to PIDS statement regarding treatment of infants and young children.Patients without Express Scripts CoverageThe co-formulated compounded version also is available for 99 cents per capsule to $1.29 per capsule depending on the strength for patients who are not covered by Express Scripts, but they will be responsible for the full cost. Imprimis staff will contact the patient or the hospital for payment information. Hospitals may set up accounts with Imprimis. As of early December 2015, other insurers or pharmacy benefits managers have not yet announced that they will be covering this alternative, although that is under consideration.
Access to Daraprim
Click Here to Access the Daraprim Order Form
For issues, email: firstname.lastname@example.org or call: (877) 258-2033
Also see Daraprim Direct
More information on eligibility criteria for the Daraprim patient assistance program is available from the Fair Pricing Coalition.
Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adolescents and Adults
For situations where pyrimethamine cannot be obtained, the Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adolescents and Adults were updated in October 2015 to provide guidance to clinicians on the use of the alternative treatment using trimethoprim-sulfamethoxazole.
The HIV Medicine Association is the professional home for nearly 5,000 physicians, scientists, and other health care professionals dedicated to the field of HIV/AIDS. Nested within the Infectious Diseases Society of America, HIVMA promotes quality in HIV care and advocates policies that ensure a comprehensive and humane response to the AIDS pandemic informed by science and social justice.
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