Important note: Information in this article was accurate in 1996. The state of the art may have changed since the publication date.
The Miami Herald, Inc.; Saturday, September 7, 1996
Karen Rafinski, Herald Staff Writer
"It's not a question of whether to offer them because we need to have equal access," said Dr. Paul Arons, who heads the task force commissioned by the state Department of Health. "It's a question of how do we pay for it."
In town Friday for a state conference in Miami Beach on AIDS and other infectious diseases, Arons said he hopes the drugs can be offered by the end of the year, at least on a limited basis.
Florida AIDS workers have joined with their counterparts in the other 50 states to submit a plan to Congress for $154 million in federal funding to help buy the new drugs.
Protease inhibitors have reduced the amount of HIV in the blood below detectable levels in some studies and are believed to dramatically lengthen and improve the lives of AIDS patients. But at a cost of more than $10,000 a year they are available only to the well-off, the well-insured and the sickest patients on Medicaid.
The Department of Health roughly estimates that it would cost the state $20 million to $22 million to offer protease inhibitors to the 2,500 AZT patients now in the state's AIDS
Drug Assistance Program, said James Jackson, chief of disease intervention for the department. That's far more than the $13 million now being spent on the program to offer 10 AIDS drugs. But the cost could balloon once the drugs are offered because many people who can't afford them now are expected to apply for the program. Last year when the state offered a new AIDS drug to its list of 10 approved drugs, demand for the program went up 40 percent, Arons said.
"When you open the floodgates the results are hard to gauge," Jackson said.
Plus, the state will still have to find a way to pay for the expensive viral load testing needed to effectively use the new drugs. The federally funded drug program won't cover those costs.
The $154 million in federal funding requested by the consortium of state AIDS workers would give Florida $15 million to help pay for the drugs, Jackson said. But in these tight budgetary times, no one is sure of the odds for success.
The health department also hopes to get about $5 million from the state Legislature to close the gap, Jackson said. But it will be some time before those funding streams are approved and in place.
In the meantime, the new task force is charged with finding ways to offer the drug more quickly. Composed of 20 doctors, activists, community organizations and representatives from all the cities and agencies that now get various pots of federal AIDS money, the group will look at various cost-cutting measures that would free up more money to supply the drugs.
That could mean allowing the state to purchase the drugs for the various community groups that distribute them in order to use the state's negotiating clout to get the best price and stretch the drug budget, Arons said. Or it could involve consolidating programs to avoid duplicated services or other pooling of resources.
If the State Drug Assistance Program does begin to offer the drugs, it could open the opportunity for the new therapy to many in Dade County, where the drugs aren't available outside of Medicaid, private insurance or a smattering of charitable programs.
Published by: The Miami Herald, Inc.; a Knight Ridder publication. One Herald Plaza, Miami, FL 33132-1693
Copyright (c) 1997 Miami Herald. All rights reserved. Reprint Permission: The contents of each issue of The Miami Herald are protected under the federal copyright act. Reproduction of any portion of any issue will not be permitted without the express permission of The Miami Herald. Reprints: 305-376-3719 Staff photos: 305-376-3756. Internal or personal use: Copyright Clearance Center, 508-750-4283, ext. 888; fax 508-750-4744. The Miami Herald or Knight Ridder shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon.
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