Newspaper article St Louis Post-Dispatch (MO)

Expensive Treatments Hamper Aids Programs States Have Trouble Financing Low-Income Patients

Newspaper article St Louis Post-Dispatch (MO)

Expensive Treatments Hamper Aids Programs States Have Trouble Financing Low-Income Patients

Article excerpt

STATE AFTER STATE is running low on money to buy the latest, most potent AIDS drugs for thousands of low-income Americans.

Last month Washington became the latest state, following Illinois and Kansas, to cut dramatically its AIDS Drug Assistance Program as it tried to avert almost certain bankruptcy.

More cutbacks are pending as states scramble to cover unexpected bills for today's patients. That's not even counting the thousands suddenly demanding treatment because of headlines promising new hope for treatment of AIDS.

And as many as 20 states haven't begun offering the newest drugs as they grapple with the costs.

"For all the folks drowning in the sea of HIV disease, all of a sudden there's a lifeboat . . . and, when they swim to it, it's full," said Washington AIDS Director Mariella Cummings. She temporarily shut that state's AIDS drug program after a 76 percent jump in AIDS patients between January and June pushed her bills from $53,000 a month to $144,000.

"That's the image I wake up with and go to sleep with," she said. "How are we going to get some more lifeboats in the water?."

At issue are state AIDS Drug Assistance Programs that buy medicine for uninsured HIV-infected people who don't qualify for Medicaid because they're not quite poor enough or sick enough.

This fiscal year through Sept. 30, staff personnel in these programs will spend $145 million buying drugs for 65,000 Americans. That includes an extra $52 million in emergency funds that President Bill Clinton allotted this spring in anticipation of the crisis, money many states say is all that's keeping them afloat.

The programs are in trouble mainly because of new drugs called protease inhibitors that, when combined with two older drugs, are so potent that AIDS patients have their first hope of truly longer and healthier lives.

But these three-drug cocktails cost $10,000 to $15,000 per person per year. That doesn't count the myriad other drugs taken to fight pneumonia and other deadly illnesses that stalk AIDS patients.

And proteases have a unique problem: Stopping taking them for even a month because the program temporarily ran out of money can allow HIV to mutate rapidly into a virtually untreatable strain. …

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