Here's a recent article on treatment costs:
(article and graphic on costs on various drugs can be found at):
news-observer.com
New AIDS treatments put strain on
programs for poor
By CATHERINE CLABBY, Staff Writer
North
Carolina health
officials say they
can no longer
afford to pay the
drug bills of all
low-income
AIDS patients
eligible for their
help, meaning
some people may
not get access to
life-extending
medicines.
"I don't know
what we're going
to do, I just don't," said Trish Bartlett, a social worker who
works with AIDS patients at Duke University. "This has been a
lifeline for us."
The N.C. AIDS Drug Assistance Program has stopped
accepting new clients because the high cost of new drug
therapies is quickly eating up its $3.6 million budget, said Arthur
Okrent, who runs the state's AIDS care branch.
Drug assistance programs all over the country are facing
similar problems. Many have taken emergency measures to limit
costs, including setting up waiting lists and restricting the drugs
they will pay for.
The crisis is a side effect
of the success of a triple-drug
AIDS therapy that became
the preferred treatment last
winter. The drugs are credited
with extending the lives of
thousands of patients, and
their success is encouraging
people infected with HIV, the
virus that causes AIDS, to
seek early treatment.
The downside is that the
drugs cost as much as $1,500
a month, and programs such
as North Carolina's haven't
set aside enough state or
federal money to cover the
cost for everyone who needs
them. "Fewer people are
dying, more people are
signing up and the cost of
treatment is increasing,"
Okrent said.
Members of the N.C.
AIDS Advisory Council on
Monday said they were
frustrated that the state's
action came without warning. As recently as August, members
had asked Okrent whether the program was stable and he said
yes.
"Just a couple of months ago we were told that everything
was fine," said David Jones, a council member from Chapel
Hill.
Okrent said demand for treatment has surged since August.
Medication costs were $428,000 in August, but rose to
$648,000 in September, he said.
Last year, about 1,140 people used the medication
program, which is designed to help uninsured and low-income
people who are not sick or poor enough to qualify for
Medicaid.
In September of 1996, the average participant's monthly bill
was $250. Last month it was more than $1,000.
Kimberly Scott, executive director of the Eastern N.C.
AIDS Consortium, said she worries most about the impact this
limit will have on people who live in rural or remote parts of the
state, where the virus is spreading.
"People are beginning to see the results of these drugs
among their peers. They are coming in and saying 'Yes, I want
to be tested and I want treatment,' " she said. "This is going to
impact the level of trust we have established."
Okrent said his staff decided to limit new enrollment rather
than risk running out of money and being unable to cover the
bills of patients already enrolled. People who take the new
drugs and then stop can develop drug-resistant strains of HIV
which they could then transmit to others, he said.
While his staff expects they may encounter a $500,000
shortfall by the end of the fiscal year in March, Okrent said they
will find a way to pay the bills of everyone now enrolled.
Denying this medication will take a toll on people who
already are struggling, said Don Barefoot, an uninsured Durham
waiter who depends on the state program to pay for his AIDS
drugs.
"It's bad enough when you find out about the diagnosis. But
to hear about promising new drugs and you can't apply for it?"
he said. "It's just one more sword through the heart."
Catherine Clabby can be reached at 829-4871 or
cclabby@nando.com
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