Funding crunch flattens HIV/AIDS drug access

Physicians and experts envision a national program for HIV/AIDS care that would provide a steady stream of funding for drugs and services.

By Joel B. Finkelstein, AMNews staff. June 14, 2004.

Washington -- Patients in many states are not receiving life-extending HIV antiretroviral drug therapy, and others are struggling to get services for comorbid conditions, according to the latest results of an annual survey by the Kaiser Family Foundation.

"The toughest part of the whole thing is providing comprehensive care to these patients who fall between the cracks," said Joseph Cervia, MD, director of the Comprehensive HIV Care and Research Center at Long Island Jewish Medical Center.

The survey revealed weaknesses in implementation of the Ryan White CARE Act, which was intended to fund HIV care for low-income patients who don't qualify for Medicaid.

The act enabled communities to establish locally run AIDS drug assistance programs, or ADAPs, with funding shared by the state and federal governments. But because of state fiscal problems and stark variabilities in how the programs are run from state to state, patients in some areas are experiencing overwhelming difficulties in obtaining HIV therapies.

"What people are able to get completely depends on where they live," said Jennifer Kates, the Kaiser Foundation's director of HIV/AIDS policy.

Kentucky's program, for example, gets only $90,000 a year from the state. This pays for about 10 days' worth of medicine for the program's clientele. Qualifying as a needy state, Kentucky also receives close to $500,000 a year from the federal government. That money, too, falls short, and the state is one of 10 with an ADAP waiting list.