Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
 

Advancing Access Program

This program provides brand name medications at no or low cost

Provided by: Gilead Sciences, Inc.

PO Box 13185
La Jolla, CA 92039-3185

TEL: 800-226-2056


FAX: 800-216-6857
Languages Spoken:

English, Others By Translation Service

Program Website

 

Patient Assistance Applications

Gilead Advancing Access Enrollment Form

HIV Common Application: Gilead Sciences

 

Brand Name Medications Covered

 
  • Atripla tablet
  • Stribild tablet
  • Complera tablet
  • Truvada tablet
  • Descovy
  • Tybost
  • Emtriva capsule
  • Vemlidy
  • Emtriva oral solution
  • Viread tablet
  • Genvoya tablet
  • Vistide injection
  • Hepsera tablet
  • Vitekta tablet
  • Odefsey
 

Generic Name

 
  • adefovir dipivoxil tablet
  • emtricitabine oral solution
  • cidofovir injection
  • emtricitabine/rilpivirine/tenofovir alafenamide
  • cobicistat
  • emtricitabine/rilpivirine/tenofovir disoproxil fumarate tablet
  • efavirenz/emtricitabine/tenofovir disoproxil fumarate tablet
  • emtricitabine/tenofovir alafenamide
  • elvitegravir tablet
  • emtricitabine/tenofovir tablet
  • elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide tablet
  • tenofovir alafenamide
  • elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate tablet
  • tenofovir disoproxil fumarate tablet
  • emtricitabine capsule
 

Eligibility Requirements   

Insurance Status Must be uninsured
Those with Part D Eligible? No
Income Based on FPL
Diagnosis/Medical Criteria Medically appropriate condition/diagnosis
US Residency Required? Must be a US resident
   

Application

Obtaining Call
Receiving Faxed or mailed
Returning Fax or mail
Doctor's Action Complete section and sign
Applicant's Action Complete section, sign, attach a copy of proof of income
Decision Communicated Patient and Doctor notified in writing
Decision Timeframe 3-5 business days
   

Medication

Amount/Supply Varies. *see below for details
Sent To Varies. *see below for details
Delivery Time Within 2 business days
Refill Process Patient contacts pharmacy
Limit Not specified
Re-application Varies
   

Additional Information

Insurance benefits, claims assistance and/or other reimbursement help is offered.

If the application is for Vistide, then prescription must be included because it will be sent to the doctor's office. The other medications are given using a pharmacy card. This program is for outpatient use only.

This Program participates in the CPAPA. This single common application allows uninsured HIV-positive individuals with low incomes to use one application to apply for multiple assistance programs.

IMPORTANT: Send completed CPAPA to the corresponding addresses listed for each company.


Updated May 19, 2017