Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.
New AIDS estimate by S.F. health dept.
San Francisco Chronicle - Wednesday, September 20, 1989
Elaine Herscher, David Tuller, Chronicle Staff Writer
It will cost San Francisco $60 million more a year than is now available to treat the 23,000 people in the city who are infected with the AIDS virus, according to a health department study released yesterday. In San Francisco, where experts say the model of AIDS treatment is already crumbling for lack of funds, the combined cost of AIDS treatment, excluding hospitalization and long-term care, will reach $91 million annually over the next four years, the report said. About $30 million is currently available. The report comes in response to new findings that hundreds of thousands of people who have contracted the virus but who are not yet sick may be helped by the costly drug AZT. The national cost of early intervention for those who can benefit is expected to top $5 billion a year. In his report to the San Francisco Health Commission, Dr. George Rutherford, director of the health department's AIDS office, said the only real help will be more federal assistance. "The government will give money to Puerto Rico and the Virgin Islands for hurricane Hugo. As an approach to saving 20,000 lives, the federal government shouldn't be quibbling about whether this disaster is different from that disaster," Rutherford said. A partial solution will be offered by Mayor Art Agnos' task force on AIDS, which is developing a strategy to pressure third-party payers -- such as insurance companies, self-insured employers, and Medi-Cal -- to cover the costs of early intervention. Within the next several weeks, the task force is planning to present guidelines for the mayor's approval that would establish a local "standard of care" for HIV infection. Both private and public health care programs rely on strict guidelines determined by the federal Food and Drug Administration to gauge standards of care. However, even after a drug is shown to be effective, it can take months for a drug company to formally apply for -- and receive -- FDA approval. Doctors routinely prescribe many medications, such as AZT, for use by patients who do not fall within the narrow FDA guidelines. The task force is hoping that the standards set in San Francisco will lead the way for other cities. Steve Morin, legislative aide to AIDS task force member Representative Nancy Pelosi, D-S.F., said that the guidelines will take into account the new studies on AZT's ability to delay the onset of AIDS in those infected with HIV but not yet sick. The group also expects to endorse routine doctor visits, laboratory tests, and widespread use of aerosolized pentamidine, which can prevent the onset of pneumonia in people with AIDS. "It's an orderly first step" in addressing the enormous financial difficulties of early HIV intervention, said Pat Christen, acting executive director of the San Francisco AIDS Foundation. "Once you have agreement on the standard of care, it provides ammunition to lobby the appropriate committees in Washington and to bring pressure to bear on insurance companies," she said. Rutherford said that drug therapy remains by far the biggest expense in treating people infected with the virus. Seventy percent of the $91 million a year will go toward the cost of AZT and pentamidine. This week, under pressure from advocates for people with AIDS, the manufacturer of AZT, Burroughs Wellcome Co., reduced the price by 20 percent. But even at that, the drug remains expensive, with a full dose costing about $6,400 yearly and a half dose, recommended for those without symptoms, costing $3,400. Those seeking early treatment threaten to further overwhelm a health care system already in jeopardy. Currently, people infected with the AIDS virus make 45,000 visits to public facilities.
Keywords: STATISTICS; AIDS; HOSPITALS; HEALTH; SERVICES; COST; FORECAST ; SF; S.F. HEALTH COMMISSION; GEORGE RUTHERFORD
890920
SC890913
Copyright © 1989 - San Francisco Chronicle Press. All rights reserved. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through the San Francisco Chronicle, Permissions Desk, 901 Mission Street, San Franciso, CA 94103. You may also send a fax to (415) 495-3843, or an email message to chronperm@sfgate.com. http://www.sfgate.com.
AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from Broadway Cares/Equity Fights AIDS, Elton John AIDS Foundation, the National Library of Medicine, Pacific Life Foundation and donations from users like you.
Always watch for outdated information. This article first appeared in 1989. This material is designed to support, not replace, the relationship that exists between you and your doctor.
AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.
Copyright ©1980, 1989. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .