HomeMy WebLinkAboutMINUTES - 03161993 - 1.44 ^�
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TO: BOARD OF SUPERVISORS /
,4
FROM: Mark Finucane, Health Services DireCcto IIra
By: Elizabeth A. Spooner, Contracts Administrator ^c}a
DATE: March 4, 1993 Cou /
SUBJECT: Approve Agreements with the State Department of Health Services for County's
AIDS Drug Program
SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION
I. RECOMMENDED ACTION:
A. Approve and authorize the Chair, Board of Supervisors, to execute on behalf of
the County, Amendment #29-395-7, to amend Standard Agreement #29-395 (as amended by
Amendments #29-395-1 through #29-395-6) , effective January 1, 1990 through September
30, 1992, with the State Department of Health Services, Office of AIDS, to increase
the payment limit by $35,000, from $252,366 to a new total payment limit of
$287,366, for County's AIDS drug program.
B. Approve and authorize the Chair, Board of Supervisors, to execute on behalf of
the County, Standard Agreement #29-395-8, with the State Department of Health
Services, Office of AIDS, with an allocation of $84,000 for the period from October
1, 1992 through April 30, 1993, for County's AIDS drug program.
II. FINANCIAL IMPACT:
A. Approval of Amendment #29-395-7 will result in an increased allocation from the
State (Office of AIDS) of $35,000, to a new total allocation not to exceed $287,366.
B. Approval of Standard Agreement #29-395-8 will result in an allocation from the
State (Office of AIDS) in the amount of $84,000 for the period October 1, 1992
through April 30, 1993.
The allocation covers the cost of certain drugs for eligible low income persons with
AIDS and/or AIDS related complexes and may not be used to cover administrative costs
associated with this program, nor for patient monitoring, laboratory testing, or
other medical services for persons receiving,any of the .drugs. The County may make
provisions for copayment by patients commensurate with the patient's ability to pay.
III. REASONS FOR RECOMMENDATIONS/BACKGROUND:
The State Office of AIDS has allocated to the County, by means of Standard Agreement
#29-395, which was approved by the Board on May 22, 1990, funding to cover the cost
of any drug which has been included in the AIDS Drug Program by the State and
determined by the U.S. Food and Drug Administration to prolong the life of a person
with AIDS, for eligible low income persons who are infected with the human
immunodeficiency virus (HIV) , and/or persons with AIDS and related complexes who
meet certain criteria. Subsequent amendments have increased the total payment limit
based upon actual and projected drug expenditures by the Department and extended the
term of the agreement through September 30, 1992.
CONTINUED ON ATTACHMENT: YES SIGNATURE: /
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMEN ATI N OF BOARD 60MMITTEE
APPROVE OTHER
SIGNATURE(S) 12
ACTION OF BOARD ON APPROVED AS RECOMMENDED X OTHER
VOTE OF SUPERVISORS
UNANIMOUS (ABSENT ) I HEREBY CERTIFY THAT THIS IS A TRUE
AYES: NOES: AND CORRECT COPY OF AN ACTION TAKEN
ABSENT: ABSTAIN: AND ENTERED ON THE MINUTES OF THE BOARD
OF SUPERVIS S ON THE DATE SHOWN.
Contact: Wendel Brunner, M.D. (313-6712) / /,
CC: Health Services (Contracts) ATTESTED �- 16 /7
Risk Management Phil Batchelor,Clerk of the Board of
Auditor-Controller Sucervisors and County Administrator
Contractor
M382/7-83
BY DEPUTY
Board Order
#29-395-7 & #29-395-8
Page 2
Approval of Amendment #29-395-7 will increase the maximum allocation to cover
expenditures incurred by the AIDS drug program through September 30, 1992, and
approval of Standard Agreement #29-395-8 will extend the program through April 30,
1993.
The Board Chair should sign six copies of the Amendment and six copies of the
Standard Agreement, five of which should then be returned to the Contracts and
Grants Unit for submission to the State Department of Health Services (Office of
AIDS) . .
1 -44
29 - 395 - 8
Standard Agreement for
AIDS Drug Program
October 1, 1992 - April 301, 1993
Local Health Jurisdiction Contra Costa County
The State of California by and through the Department of Health
Services (hereinafter called the Department) and the Local Health
Jurisdiction of Contra Costa County (hereinafter called the Local
Jurisdiction) in consideration of the covenants, agreements, and
stipulations hereinafter expressed or hereby agree as follows:
Article I
1. The funds allocated pursuant to this agreement are for the
cost of providing any drug included in the AIDS Drug Program
(ADP) by the Department. This includes drugs currently
provided by ADP and any drugs to be included in ADP in the
future. All ADP drugs shall be determined by the Food & Drug
Administration (FDA) to prolong the life of a person infected
with AIDS or with human immunodeficiency virus (HIV) disease,
or included by the Department because of the medical community
acceptance of a drug as a successful therapy used for the
management of HIV disease.
2 . For the purposes of this Agreement, drugs provided by the AIDS
Drug Program are listed in Exhibit A, AIDS Drug Program
Approved Drugs, and incorporated herein, and made part hereof
by this reference.
3 . The term of this Agreement is for the period October 1 . 1992
through April 30, 1993 .
4 . The maximum allocation to the Local Health Jurisdiction for
the term of this Agreement shall not exceed $84, 000.
IN WITNESS WHEREOF, this Agreement has been executed by the
parties hereto.
State of California Local Health Jurisdiction
Signature Signature AIon
Jam- /,/'
/ /��J _
4.
Chair, Board of Supervisors
Title Title _ .
1
MAR
Date Date 1 `
5. The eligibility criteria for individuals who participate in
ADP is based on the criteria as follows:
I
(a) A person must provide a valid prescription for the drug
which has been signed by a California licensed physician;
(b) Meet any other medical criteria established by the
Department which is set for each specific drug being
provided by ADP;
(c) , Meet the income criteria established by the Department
and provide proof that he/she meets the income criteria;
and
(d) The individual must not be covered under Medi-Cal or a
third party insurance company. The only exception to
this criteria is in cases where the individual's private
health insurance does not cover drugs as a benefit. ADP
funds may be used to pay for the drug costs not covered
by an enrollee's insurance if the enrollee meets all
other eligibility criteria.
Two separate financial criteria exist. The first criterion applies
to individuals who were previously enrolled in ADP prior to March
15, 1991. The financial criteria for these individuals remains as
follows:
(1) A person must earn less than $40,000 per year regardless
of the number of persons in the family unit.
For individuals who enrolled in ADP after March 15, 1991 the
financial criteria is as follows:
(1) Individuals whose adjusted annual gross income is below
400% of the federal poverty guidelines will receive the
drug at no cost.
(2) Individuals whose annual adjusted gross income is between
400% of the federal poverty guidelines and $50, 000 will
have a payment obligation to the state that is the lesser
of the following:
(a) two times their annual state income tax
liability, less funds expended by the person
for health insurance premiums, or
(b) the cost of the drugs.
6. Drugs included by the Department in the AIDS Drug Program
shall be provided to eligible individuals according to medical
guidelines and amounts not to exceed dosages specified in AIDS
Drug Program Algorithms and medical criteria made part hereof
by this reference (Exhibit B) . Any exception to these
.. guidelines shall be made upon acceptance of written
Justification of medical necessity provided by the eligible
individuals' attending physician.
Article II
1. The Local Jurisdiction shall adhere to all State instructions,
guidelines or directives pertaining to: 1) the provision of
any drug which has been included in ADP by the Department; and
2) allocation of funds for the cost of ADP drugs purchased for
distribution to eligible persons; and 3) collection of
copayments from individuals with annual adjusted gross incomes
in excess of 400% of the Federal Poverty Level. Guidelines
for the implementation of the AIDS Drug Program are specified
in Department of Health Services, Office of AIDS, Policies and
Guidelines, AIDS Drug Program, October 1992, consisting of 15
pages and is incorporated and made a part hereof by this
reference.
2 . Policies and Guidelines, AIDS Drug Program, October 1992 ,
shall be adhered to in implementing the AIDS Drug Program by
Local Jurisdictions and are made part hereof this Agreement..
The Local Jurisdiction shall comply with any revisions to
these guidelines. Any changes and/or additions to these
guidelines will be made in correspondence and notification of
such changes shall be made 30 days prior to implementation.
Any costs in performing such guidelines/activities incurred by
Local Jurisdictions shall be addressed in a Standard Agreement
amendment which the Local Jurisdiction shall negotiate with
the Department in good faith. Administrative costs associated
with such changes are not reimbursable.
3 . The Local Jurisdiction shall verify the enrollee's income on
an annual basis. An individual applying for eligibility shall
provide their most recent California State tax return, Form
540, California Resident Income Tax Return, for proof of
income and for determination of their annual adjusted gross
income. If an individual did not file a state tax return, the
individual shall fill out a payment worksheet which should be
used to determine eligibility and/or payment for the drug(s) ,
Exhibit C, and is incorporated and made a part hereof by this
reference.
4 . The Local Jurisdiction agrees that the funds will be used for
the payment of drugs which have been included in ADP by the
Department. The Local Jurisdiction may not use these funds to
cover administrative costs associated with this program, nor
for patient monitoring, laboratory testing or other medical
services for persons receiving any of the approved drugs.
5 . The maximum amount payable under this agreement as specified
in paragraph 4 of Article I shall be subject to the conditions
specified in paragraphs 4 and 6 of Article III set forth
herein. The Department reserves the sole right to amend this
contract to make the adjustments specified in paragraph 10 of
Article III.
6. The Local Health Jurisdiction shall submit cost/expenditure
reports containing information on the cost of drugs provided
and the number of prescriptions. This information shall be
submitted in a format prescribed by the Department as
displayed in Exhibit D, AIDS Drug Program Invoice Form,
consisting of one page and made a part herof by this
reference. This report shall be submitted 30 calendar days
after the last day of each month.
7. The Local Health Jurisdiction shall provide all required
statistical and demographic data necessary for the maintenance
of this program. This information shall be submitted in the
format prescribed by the Department as displayed in Exhibit E,
AIDS Drug Program Report, consisting of one page and made a
part hereof by this reference. This report shall be submitted
30 calendar days after the last day of each month. The
Department reserves the right to require each Local
Jurisdiction to provide the reports on a computerized disk.
The Department also reserves the right to require each Local
Jurisdiction to adopt a Statewide computer program for
compiling these reports. These requirements may be required
at any time during the length of the Standard Agreement upon
a 30 day notification from the Department.
8 . The Local Jurisdiction shall provide a verification of the
actual cost of the drug(s) with the invoices submitted. A
copy of the invoice received from the drug wholesaler or
entity from which the drug was purchased shall be attached to
each invoice. Invoices will not be processed without purchase
verification.
9 . All invoices for expenditures and statistical reports, copies
verifying actual cost of drugs, and other official
communications shall be mailed to:
Department of Health Services
Office of AIDS
AIDS Drug Program
P.O. Box 942732
Sacramento, CA 94234-7320
10. The Local Jurisdiction agrees to maintain necessary program
records documenting the drugs provided, identification of
persons enrolled in the program, periods of enrollment, and
fiscal expenditures made under this Agreement. Records shall
be maintained for at least three (3) years from the end of the
state fiscal year during which this Agreement is terminated,
or from the dates the final expenditure reports to the Federal
Government are submitted for costs incurred or until the
termination of all state and federal audits, whichever is
later.
11. The Local Jurisdiction agrees to provide access during normal
working hours to authorized representatives of the Department
and of other state and federal agencies to all records, files,
and documentation related to this Agreement, subject to
applicable state and federal laws concerning confidentiality.
12 . The Local Jurisdiction shall be liable for all federal and
state funds allocated under this Agreement, including but not
limited to, any audit exceptions that may arise. The Local
Jurisdiction shall submit repayment of any funds, within 30
days of written notification from the State, not spent for the
cost of providing any approved drug, or for persons who did
not meet the income eligibility guidelines, or for overcharges
of the drug(s) , or any amount that the Department assesses the
Local Jurisdiction will not expend from their allocation.
13 . If it appears the Local Jurisdiction will not expend the
entire amount of its allocation under this Agreement, the
State may redistribute any projected unexpended funds of the
Local Jurisdiction's allocation to other Local Jurisdictions.
The Department shall notify the Local Jurisdiction in writing
30 days prior to any changes in the Local Jurisdiction's
allocation.
14 . The Local Jurisdiction agrees to maintain the confidentiality
of patients who apply for eligibility under this program.
15. The Local Jurisdiction agrees to comply with the following
federal nondiscrimination requirements:
CIVIL RIGHTS: In accordance with the Department of
Health and Human Services (HHS) Office for Civil Rights,
Assurance of Compliance, Form HHS 441, with the Civil
Rights Act of 1964 .
HANDICAPPED INDIVIDUALS: In accordance with the HHS
Office for Civil Rights, Assurance of Compliance, Form
HHS 641, with Section 504 of the Rehabilitation Act of
1973 , as amended (29 USC 794) .
This provides that no handicapped individual shall,
solely by reason of the handicap be excluded from
participation in, be denied the benefits of, or be
subjected to discrimination under any program or activity
receiving federal financial assistance. The pertinent
HHS regulations are found in 45 CFR, Part 84 .
AGE DISCRIMINATION: In accordance with 45 CFR, Part 91,
attention is called to the general rule that no person in
the United States shall, on the basis of age, be excluded
from participation in, be denied the benefits of, or be
subjected to discrimination under any program or activity
receiving federal financial assistance.
SEX DISCRIMINATION: . In accordance with Assurance of
Compliance, Form HHS 639, with Section 901 of Title IX of
the Education Amendments of 1972, (P.L. 92-318) as
amended, which provides that no person shall, on the
basis of sex, be excluded from participation in , be
denied the benefits of, or be subjected to discrimination
under any education program or activity receiving federal
financial assistance. The pertinent HHS regulations are
found in 45 CFR, Part 86.
Article III
1. The Department shall authorize the payments in arrears up to
the maximum allocation of this Agreement upon the execution of
this. Agreement if all previous allocations pursuant to the
AIDS Drug Program have been fully expended.
2 . The Department will reimburse the Local Jurisdiction upon
receipt of invoice forms, any amount expended by the Local
Jurisdiction for the provision of approved drugs, but not
exceeding the maximum amount reimbursable under this
Agreement. Reimbursements to the Local Jurisdictions will be
contingent upon receipt of the AIDS Drug Program Invoice Form.
3 . The Department of Health Services will reimburse the
Contractor for approved drugs provided at rates (Exhibit F)
specified by the Department and incorporated herein and made
a part hereof by this reference. Any new drugs approved and
added to the AIDS Drug Program shall be reimbursed at rates
specified by the Department in correspondence which will be
made part hereof by Standard Agreement amendment.
4 . The Department shall recover any funds which are not expended
in accordance with this Agreement. Recovery of funds may be
accomplished by withholding payments to the Local
Jurisdiction, or upon written notification from the State.
The Local Jurisdiction shall submit repayment within 30 days
of receipt of that notification.
5. This Agreement is valid and enforceable only to the extent
that sufficient funds are made available to the State by the
United States Government and or by the State, for the purposes
of this program. If sufficient federal and/or state funds are
not made available pursuant to the Agreement, this Agreement
shall be invalid and of no further force and effect. -In this
event, the State shall have no liability to pay any state
funds whatsoever to the Local Jurisdiction, or furnish any
other considerations under this Agreement and the Local
Jurisdiction shall not thereafter be obligated to perform any
duties of this Agreement.
6 . The Department may expand or decrease the maximum income level
for the income eligibility criteria at any time during the
project time period if it is determined the income criteria
are too stringent, too expansive, and cost reports and
projections indicate possible non-expenditure or over
expenditure of the State's total allocation. The Department
shall send written notification 30 days prior to any changes
in eligibility guidelines.
7. This Agreement is subject to any additional restrictions,
limitations or conditions enacted by the Congress or the State
Legislature which may affect the provisions, terms or funding
of this Agreement in any manner.
8. The terms of this Agreement may be modified in writing upon
mutual consent of both parties.
9. This Agreement may be terminated at anytime without cause by
either party by giving 30 days prior written notice to the
other. Notification shall state the effective date of the
termination.
10. Notice of the termination by the Local Jurisdiction shall be
followed within 30 days by a final report and a final claim
for reimbursement, or repayment of funds disbursed but not
expended and, therefore, subject to recovery by the State.
11. An adjustment may be made on the allocation to increase the
amount of the payments over the Local Jurisdiction's maximum
allocation if more funds become available. Adjustments may
also be made to decrease the payments if it is determined that
the Local Jurisdiction will not expend its full maximum
allocation.
EXHIBIT A
AIDS DRUG PROGRAM APPROVED .DRUGS
In addition to zidovudine (AZT) and aerosolized pentamidine, the
following eight drugs have been officially added to the AIDS Drug
Program as of November 12, 1991.
1 - SULFADIAZINE (N1-2-PYRIMIDINYLSULFANILAMIDE) is administered
orally and is recommended in lieu of SULFADOXINE/PYRIMETHAMINE
because SULFADIAZINE does not possess the adverse side effects
associated with SULFADOXINE/PYRIMETHAMINE. SULFADIAZINE is
used as a prophylaxis and treatment for Toxoplasma gondii of
the Central Nervous System.
2 - CLINDAMYCIN (CLEOCIN) is administered orally and is
recommended as a specific treatment for toxoplasmosis of the
brain, an opportunistic infection associated with the central
nervous system. The onset of toxoplasmosis causes neurologic
abnormalities consistent with intracranial diseases and may
cause a reduced level of--consciousness. CLINDAMYCIN is an
alternative to the drug PYRIMETHAMINE which also treats
toxoplasmosis.
3 - TRIMETHOPRIM/SULFAMETHOXAZOLE (TMP/SMZ) (BACTRIM) is
administered orally and is used for PCP prophylaxis. It is
usually the initial drug of choice for PCP prophylaxis and is
a prelude to aerosolized pentamidine.
4 - PYRIMETHAMINE (DARAPRIM) is administered orally and is used to
treat the opportunistic infection toxoplasmosis.
5 - DIAMINODIPHENYLSULFONE (DAPSONE) is administered orally and is
an antibacterial drug that is usually used in conjunction with
aerosolized pentamidine or pyrimethamine as a PCP prophylaxis.
6 - GANCICLOVIR (CYTOVENE) is administered intravenously to combat
against the opportunistic infection cytomegalovirus (CMV)
retinitis. CMV produces distinct patches of retinal whitening
with distinct borders and eventually spreads to blood vessels.
As it progresses it results in hemorrhaging and death of the
tissue itself.
7 - NYSTATIN (MYCOSTATIN) is administered orally and is used . for
the treatment and prevention of oral candidiasis.
8 - DIDANOSINE (ddI) , VIDEX - VIDEX is indicated for treatment of
patients with advanced HIV infection who are intolerant of
zidovudine therapy or who have demonstrated significant
clinical or immunologic deterioration during zidovudine
therapy.
The following three drugs are scheduled to be added to the AIDS
Drug Program in April 1992.
9 - FLUCONAZOLE (DIFLUCAN) is administered orally or intravenously
and is useful for the treatment of (1) systemic infections
caused by dimorphous fungi, (2) dermatophytosis, a fungal
infection of the skin (3) cryptococcosis, an infection of the
skin or lungs but primarily the brain. The cutaneous form is
marked by lesions and the generalized form invades the central
nervous system, and (4) Oral candidiasis, an infection that
attacks the esophagus producing pain when swallowing. Oral
candidiasis is characterized by the gross appearance of white
patches or plaques on the esophagus.
10 - KETOCONAZOLE (NIZORAL) is administered orally and is used for
the treatment of systemic fungal infections such as
candidiasis, chronic mucocutaneous (skin and mucous membrane)
candidiasis, and Oral Candidiasis.
11 - CLOTRIMAZOLE (MYCELEX) is administered orally and has been
proven effective in the treatment of oropharyngeal candidiasis
(oral thrush) , characterized by the appearance of whitish
spots in the mouth.
The following two drugs represented the AIDS Drug Program prior to
November 12, 1991.
12 - ZIDOVUDINE (AZT) is administered orally and is indicated for
the management of patients with HIV infection who have
evidence of impaired immunity(CD4 cell count of 500/mm3 or
less) before therapy is begun
13 - AEROSOLIZED PENTAMIDINE is indicated for the prevention of
Pnemocystis carinii pneumonia (PCP) in high-risk, HIV-infected
patients defined by one or both of the following criteria. (1)
A history of one or more episodes of PCP or (2) A peripheral
CD4+ (T4 helper/inducer) lymphocyte count less than or equal
to 200/mm3 .
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State of California Office of AIDS Department of Health Servi
AIDS Drug Prog
PAYMENT WORK SHEET
This work sheet is part of the ADP application for services--it is required for persons/families
who did not file a California State Income Tax Return for the previous tax year.
A. (First Name) (Last Name)
B. Social Security # or I.D. # Client's Birthdate
C. Present Home Address (Street, City, State, ZIP Code) County of Residence
California State Income Tax Return was NOT FILED because:
[ ] a. Income was below minimum required for filing. (Complete item 12 and sign form.)
( ) b. Not a California resident that year.
E ] c. Other--Please specify:
Filing Status (Check only one.)
[ ) 1. Single.
E ) 2. Married filing joint return (even if only one had income).
E ] 3. Married filing separate return. Enter spouse's Social Security number and name.
E ] 4. Head of household. Enter name and relationship of qualifying person. Do not claim this person as a dependent.
Name: Relationship:
[ ) 5. Qualifying widower) with dependent child.
Exemptions:
E ] 6. If someone (such as your parent) can claim you as a dependent on his or her tax return, check here, skip tines
7-10 and enter zero (0) on line 11.
7. Personal: If you checked filing status 1,3 or 4 above, enter $58. if you checked box 2 or 5, enter $116. 7. S
8. Blind: If your spouse is visually impaired, enter $58. If both are visually impaired,
enter 5116....... 8. 3
9. Senior: If you or your spouse is 65 or older, enter $58. if both are 65 or older, enter 3116........... 9. S
10. Dependents: Enter name and relationship. Do not include yourself, spouse, or person listed in lines 1 to 5 above.
Name: Relationship:
Name: Relationship:
Number of dependents x $58............................................................... 10. $
11. Total exemption credits. Add lines 7 through 10. Enter here ............................................ 11. $
12. Gross Income (wages, salaries, tips, interest, dividends, ete.;if applicable, annualize current pay stub) 12. S
13. Tax. Use the amount on line 12 to find your tax from the Califonia Tax Tables........................... 13. S
14. Tax liability. Subtract line 11 from line 13. (if less than zero, enter zero.).......................... 14. $
MONTHLY PAYMENT OBLIGATION FOR CONTRACT YEAR (tax Liability times .167 or by 1/6)......•......................... S
INSTRUCTIONS: This form is to be completed in accordance with the instructions and requirements of the California State Franchise
Board as they apply to California residents and income for 1990. All required schedules, forms, and documentation must be atta,
to this work sheet.
Under penalties of perjury, I declare that 1 have examined this form, including accompanying schedules and statements, and to the 1
of my knowledge and belief it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all informa
of which preparer has any knowledge.
County Representative Signature Your Signature Date
SIGN
HERE
Title County Date
EXHIBIT D
AIDS DRUG PROGRAM INVOICE FORM
This form must be submitted with the original signatures. Copies
may be retained for the local health jurisdiction's records.
1. Local Health Jurisdiction:
2. Address:
3 . Invoice for the month of 19
4. Total number of persons provided with drugs for month
invoiced•
5. Total cost of drugs:
6. Total cost of dispensing fees:
7. Amount reimbursed by insurance:
8. Total amount of copayment:
9 . Total cost of drugs and dispensing fees:
10. Net amount reimbursed by State ADP (9 - [ 7 + 8] ) :
Report prepared by:
Name
Telephone
I hereby certify, under penalty of perjury, that the above services
have been provided in accordance with the policies, guidelines and
standards of the State Department of Health Services and that the
fees do not exceed those authorized for this program above.
Signature of a Duly Authorized Local Date
Health Jurisdiction Official
----OFFICE OF AIDS USE ONLY----
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EXHIBIT F
(a) AZT - 1.37 PER 100 MG CAPSULE
(b) Aerosolized pentamidine: $93.81 per 300 mg vial; plus $15.00
for each Respirgard II Nebulizer System, not to exceed two
nebulizers per patient per month.
(c) Clotrimazole
100 MG VAGINAL TABS - $13.97 PER 7 tablets - $1.996 PER TABLET
500 MG VAGINAL TABS - $11.18 PER tablet
1% CREAM 15 GM TUBE - $8.82
1% CREAM 30 GM TUBE - $14.94
116 CREAM 45 GM TUBE - $18.14
1% CREAM 90 GM TUBE - $24.83
1% LOTION 30 ML BOTTLES - $15.40
19o- SOLUTION 10 ML PLASTIC BOTTLE - $7.75
1% SOLUTION 30 ML PLASTIC BOTTLE - $16.13
10 MG TROCHES SUPPLIED IN BOTTLE OF 70 - $42.78
10 MG TROCHES SUPPLIED IN BOTTLE OF 140 - $77.66
(d) ketoconazole
200 MG TABS BOTTLE OF 100 - $220. 65 - $2.2065 PER TABLET
2% CREAM 15 GM TUBE - $11. 01
.2% CREAM 30 GM TUBE - $18.52
2% CREAM 60 GM TUBE - $28 . 12
(e) fluconazole
50 MG TABS BOTTLE OF 30 - $110. 53 - $3 . 68 PER TABLET
100 MG TABS BOTTLE OF 30 - $173 . 68 - $5 .79 PER TABLET
200 MG TABS BOTTLE OF 30 - $284 . 21 - $9.47 PER TABLET.
(f) (bactrim) Trimethoprim and Sulfamethoxazole
. 062 PER TABLET
(f) bactrim (cont. )
.067 PER DOUBLE STRENGTH TABLET
(g) Dapsone
. 16 PER 25 MG TABLET
. 17 PER 100 MG TABLET
(h) Sulfadiazine
. 118 PER 500 MG TABLET
(i) Clindamycin
.55 PER 75 MG CAPSULE
$1.019 PER 150 MG CAPSULE
$1.937 PER 300 MG CAPSULE
(j) Ganciclovir
$33 . 06 PER 500 MG VIAL
(k) Pyrimethamine
. 29 PER 25 MG TABLET
(1) Nystatin
Oral Tablets - . 50 PER 500, 000 UNITS
Pastilles - . 66 PER 200, 000 UNITS
Vaginal Tablets - . 83 PER 100,000 UNITS
Oral Suspension - 60cc BOTTLE . 0597 PER cc
Cream - 15 GRAM TUBE - $1.43
Cream - 30 GRAM TUBE - $2 . 22
Ointment - 15 GRAM TUBE - $1.46
Ointment - 30 GRAM TUBE - $2.84
(m) ddI
. 34 PER 25 MG TABLET
(m} ddI (cont. )
.68 PER 50 MG TABLET
$1.36 PER 100 MG TABLET
$2 . 05 PER 150 MG TABLET
100 MG POWDER - $41.05 PER PACKET OF 30
167 MG POWDER - $68.55 PER PACKET OF 30
250 MG POWDER - $102 .62 PER PACKET OF 30
375 MG POWDER - $153 .93 PER PACKET OF 30