Rationing Costly AIDS Drugs
January 13, 2004
As the AIDS epidemic moves deeper into low-income populations, expensive drugs such as Fuzeon (at roughly $20,000 a year, it costs three times as much as most AIDS medicines) are helping create a kind of rationing of HIV care common in poor nations but until now, rarely seen in the United States. Just two months after North Carolina enrolled its first Fuzeon patients this summer, the program ran out of money for new patients. Struggling with increased demand and limited budgets, 13 states have shut enrollment to new patients, leaving patients with few options.
State and federal officials who run AIDS Drug Assistance Programs (which make treatments available to patients without insurance or enough money) estimate they will need an extra $215 million in federal funding this year over the $714 million received last year, to cover current and new patients expected to apply for help. Congress, so far, has proposed a $35 million increase.
- The crisis has forced ADAP administrators to ration treatment by starting waiting lists or tightening income-eligibility criteria.
- More than 700 people nationwide are waiting to get access to any kind of treatment through AIDS Drug Assistance Programs.
- Without additional funding, that list could grow to 7,000 this year, according to the ADAP Working Group, a coalition of drug makers and AIDS organizations.
Some states have decided that Fuzeon is just too expensive and aren't buying it. In Alabama, legislators cut the funding of the state's AIDS and HIV-related assistance programs by $1.5 million for this year. Currently, there are 233 patients on the state's waiting list. Doctors there advised against buying Fuzeon, because they said it would force the ADAP program to deny patients on other drugs.
Source: Vanessa Fuhrmans, "Costly New Drug For AIDS Means Some Go Without: Programs for the Uninsured Are Facing Tough Choices With Advent of Fuzeon," Wall Street Journal, January 13, 2004.
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