GOVERNMENT & MEDICINE

Patients face loss of subsidy for AIDS drugs

Physicians in several states worry about budget cuts that could end access to life-saving combination therapies.

By Michael J. Bernstein, AMNews correspondent. Aug. 19, 2002.

Washington -- Mary O'Hearn, MD, worries her patient's confession foreshadows worse things to come. The drugs to treat his HIV/AIDS should be taken every 12 hours. But the costs are so high he'd begun taking them every 18 hours. She explained to him that his attempt to afford his medication was jeopardizing his health.

The Portland, Ore., internist who specializes in HIV/AIDS treatment fears she'll soon hear an even more tragic story -- that of a patient being forced completely off drug therapy.

Her concern is justified. In May, Oregon froze enrollment in its AIDS Drug Assistance Program, putting access to medications in doubt for the 20 to 25 patients who apply each month.

And Oregon is not alone in its step to restrict its ADAP program. State budget crunches nationwide are forcing many to limit these state-administered programs to rein in spending.

Physicians such as Dr. O'Hearn are seeing the impact.

"Many of these patients are afraid they will lose their ability to pay for these drugs," she said. "I can't imagine a worse thing than taking an HIV/AIDS patient, who is feeling well and doing well, off the treatment. You know their condition will deteriorate, and then it takes a long time to recover immunity."

Federal legislation created ADAP in 1990, but it really began to have an impact in 1995 when combination drug therapy became standard treatment. The program provides medication to low-income patients who are ineligible for health insurance or cannot afford it. ADAP is funded primarily by the federal government, but most states also contribute revenue. [...]

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