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AIDS Drugs Take Financial Toll on Patients

Posted on: Thursday, 1 December 2005, 15:00 CST

By Czerne M. Reid, The State, Columbia, S.C.

Dec. 1--Nine years ago, a 20-year-old Columbia man -- who was having sex with other men without a condom -- got the shingles. At his age, that was a strong signal that he might have the HIV virus. Tests confirmed it.

The man (he wishes to keep his identify secret) started on a battery of expensive HIV antiretroviral medications, taking up to 15 pills a day. Now he's down to four.

Working as a gas station convenience store clerk but uninsured, he can only keep taking the medicine with help from the South Carolina AIDS Drug Assistance Program (ADAP).

"Without the help of ADAP, I probably wouldn't be alive. I couldn't afford the drugs," said the man, who is single. "It's providing my life."

New medicines and improved prevention and services have helped many people with HIV/AIDS live long and productive lives. But the price tag is high.

The three medications the man takes, Reyataz, Truvada and Norvir, have a retail price of close to $2,000 a month -- $24,000 a year. He earns $16,000.

"HIV is not just a health issue, it's also an issue of economics," said Carmen Julious, executive director of Palmetto AIDS Life Support Services.

The drug assistance program covers all FDA-approved anti-retroviral medicine and treatments for some so-called opportunistic infections such as shingles and pneumonia. It helps with insurance premiums, co-payments and deductibles.

It also covers anti-depressants.

"Discovering you're HIV positive is very shocking and can send someone into depression," said Lynda Kettinger, director of DHEC's STD/HIV division.

South Carolina's ADAP helped close to 3,000 people pay for their medications and insurance last year.

Facing increasing demand, and budget shortfalls, people in charge of the program here have found ways to keep it running without cutting services.

The program got $14 million in federal funding and $500,000 from the state last year. The funds have increased only slightly every year for the previous few years. Officials stretch dollars through negotiated drug discounts, lower-cost generic drugs and keeping administrative costs low.

South Carolina also got low drug pricing as a public health service provider, and benefited from a $1.3 million supplemental grant last year, but officials are not sure if they will get the grant in coming years, said S.C. ADAP director Melissa Villnow.

But other states have been forced to limit the help they give; for instance, North Carolina's waiting list averaged almost 400 people between July 2002, and March 2005, according to the Kaiser Family Foundation. Some have died while on a waiting list.

Nurse practitioner Pat Derajtys, who has worked at the Ryan White Clinic in Columbia for 12 years, sees how the program is vital.

"People with HIV do remarkable things once they start getting well. We have a lot of patients who go back to school, become very productive in their lives."The 29-year-old Columbia man still works at the gas station, but now spends five hours a week at a local agency counseling other HIV-positive patients.

"I could see there was a need for people who were infected to help others who are newly diagnosed. It's good to have someone who is going through what you're going through to talk to."

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Copyright (c) 2005, The State, Columbia, S.C.

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Source: The State (Columbia, S.C.)

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