An ongoing dialogue on HIV/AIDS, infectious diseases,
March 10th, 2009
Unwelcome Visitor: Cost of HIV Meds
Those of us who practice HIV medicine in Taxachusetts (warning, click link at your peril) live a pretty charmed life, at least so far as getting HIV medications paid for. Due to an incredibly generous AIDS Drug Assistance Program (ADAP), rare is the patient who faces financial barriers getting his or her drugs.
(By the way, we abbreviate it “HDAP” here, not ADAP. And we treat early syphilis with two shots of penicillin, not one. And we voted for McGovern. And we drive on the left.)
But the recent downturn in the economy has changed this usually comfortable situation in the Bay State.
A patient of mine called to tell me that his co-pay for a 3 month supply of his antivirals is now nearly $2000. Another one has simply stopped coming to appointments, as his wife’s insurance has such a large deductible that he will only agree to blood tests, not an actual office visit. A third asked me whether he would be better off stopping enoxaparin or his HIV meds, since he couldn’t afford both.
I am sure things are much worse in other States — after all, Houston’s Joe Gathe initially tried lopinavir/r monotherapy since he reasoned that some ART was better than none, and his patients couldn’t afford triple-therapy.
Where is this headed? It’s tough to make predictions (especially about the future), but I suspect that when 3TC and saquinavir become generic, we might be turning to them more often than we’d previously thought.
Paul E. Sax, MD
Associate Editor
NEJM Clinician
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