How to Help Your Patients Save Money on Tesamorelin: A Provider's Guide to Savings Programs

Tesamorelin (Egrifta SV, Egrifta WR) costs between $2,400 and $2,800 per month at retail — making it one of the more expensive specialty medications your HIV patients may need. Even with insurance, patients often face significant cost-sharing. The good news: a comprehensive ecosystem of financial assistance programs exists, and providers who actively connect patients to these resources can dramatically improve medication access and adherence. This guide covers every program available in 2026.

The Financial Burden of Tesamorelin: Why It Matters for Adherence

Because tesamorelin's effects on visceral fat are not sustained after discontinuation, adherence is clinically critical. A patient who stops because they can't afford a refill loses all their visceral fat reduction progress. For a medication population — HIV patients on long-term antiretroviral therapy who are already navigating significant treatment complexity — out-of-pocket cost is one of the top drivers of non-adherence.

As their prescribing provider, you are uniquely positioned to connect patients to savings programs at the point of prescription. The earlier in the treatment journey patients are enrolled in support programs, the fewer adherence gaps they experience.

Program 1: THERA Co-Pay Assistance Program (Commercial Insurance)

Theratechnologies offers the THERA Co-Pay Assistance Program for patients with private or commercial health insurance. This program can significantly reduce the patient's out-of-pocket cost for Egrifta WR or Egrifta SV beyond what insurance covers.

How to activate for your patients: Enroll through the THERA Patient Support program at the time of prescribing. The program manages co-pay enrollment automatically for eligible patients. Contact: 1-833-23-THERA (1-833-238-4372) or hcp.egriftawr.com.

Eligibility restriction: Government-insured patients (Medicare Part D, Medicaid, TRICARE, federal employee plans) are NOT eligible for the co-pay program due to federal anti-kickback regulations. See Medicare-specific options below.

Program 2: THERA Patient Assistance Program (Uninsured/Underinsured)

For patients with no insurance, denied coverage, or who cannot afford their share of the cost, the THERA Patient Assistance Program provides tesamorelin at no cost to qualifying patients. Eligibility is based on income and insurance status. This program is managed through the THERA Patient Support infrastructure.

Provider action: Include the patient assistance program application as a routine part of your prescribing workflow for tesamorelin. THERA Patient Support handles most of the paperwork. Call 1-833-23-THERA or visit hcp.egriftawr.com for enrollment forms.

Program 3: Medicare Part D — Out-of-Pocket Cap and Alternative Funding

Starting January 1, 2025, the Medicare Part D annual out-of-pocket maximum is $2,000. For patients on tesamorelin — a specialty-tier drug — this cap is critically important. Once a Medicare patient has paid $2,000 out of pocket for covered drugs in a calendar year, Part D pays 100% of their covered drug costs for the rest of the year. For a medication that costs $2,400–$2,800 per month, most patients will hit this cap in the first month of the plan year.

Additionally, THERA Patient Support can assist Medicare patients in accessing alternative funding resources that may further reduce out-of-pocket costs. Ask your patients to contact 1-833-23-THERA for a review of all available options for their specific Medicare plan.

Program 4: Ryan White HIV/AIDS Program

The Ryan White HIV/AIDS Program is a federal funding source that supports comprehensive HIV care for low-income people living with HIV who are uninsured or underinsured. Ryan White Part B funding flows through state health departments and can cover HIV-related medications. Whether tesamorelin is covered depends on your state's formulary — but many Ryan White grantees include specialty HIV-related medications.

Provider action: If your practice participates in Ryan White programming, check whether tesamorelin is covered under your local Ryan White program formulary. Direct eligible patients to your local AIDS Drug Assistance Program (ADAP) coordinator for enrollment.

Program 5: State AIDS Drug Assistance Programs (ADAPs)

ADAPs are state-administered programs funded through Ryan White Part B that provide HIV-related medications to low-income, uninsured, or underinsured patients. ADAP formularies vary significantly by state — some include tesamorelin and some do not. Check with your local ADAP coordinator or visit NACo.org/ADAP or AIDSVu.org for state-by-state ADAP formulary information.

Program 6: Prescription Hope (Third-Party Advocacy Service)

Prescription Hope is a third-party medication access advocacy service that works with pharmaceutical companies' patient assistance programs on behalf of patients. For a monthly service fee of $70 per medication, they manage the patient assistance program application process and advocate for patients who qualify based on income criteria. This is not an insurance plan or a discount program — it is a service for patients who need help navigating manufacturer assistance programs.

Building a Tesamorelin Access Workflow for Your Practice

The most effective practices have a defined workflow for prescribing high-cost specialty medications. For tesamorelin, we recommend:

At the point of prescribing: Verify insurance type (commercial vs. government). If commercial, enroll in THERA Patient Support and activate co-pay assistance. If government or uninsured, enroll in THERA and explore PAP eligibility.

During prior authorization: THERA Patient Support handles PA submissions — make sure the enrollment form with patient consent is complete and submitted before the PA request goes in.

If PA is denied: Work with THERA's appeals team. Also check whether the patient qualifies for Ryan White or ADAP if commercial insurance denies coverage.

Ongoing: At annual reviews, recheck whether the patient's financial situation or insurance status has changed — eligibility for assistance programs shifts as circumstances change.

When your patients encounter stock availability issues beyond financial hurdles, direct them to medfinder for providers — which calls specialty pharmacies on their behalf to locate available stock. For more on navigating specialty pharmacy access, see our full provider guide on how to help your patients find tesamorelin in stock.