Being Alive; June 1997

This requested increase includes Federal funds "earmarked" for ADAPs established under Title II of the Ryan White CARE Act of 1990.

The projected increase is based on a proven pharmacoeconomic model that includes the rate of monthly growth in applications to State ADAPs, with an average monthly enrollment increase of 1,000 people nationwide. Future prescribing practices are also accounted for in the model. This model presumes that 80% of people will be prescribed triple combination therapy; 10% will receive combination antiretroviral therapy with two drugs; and 10% will not receive any hiv therapy because of intolerance or patient choice.

"A Sound Public Health Investment"

Gary Rose, treatment coordinator for the AIDS Action Council, emphasized that "what we seek here is neither a handout nor an entitlement. It is a sound public health investment that will save patient lives, bring many individuals with hiv/aids back into the workforce, dramatically reduce the costs associated with hospital and hospice care, and decrease specialist treatment for a wide range of opportunistic infections and aids-related cancers, whose incidence has fallen dramatically over the fifteen months since combination therapy with protease inhibitors has been widely adopted in medical practice."

Rose also noted that White House support for the use of the new drugs has increased with the availability of hard data on cost savings in the hospital, long-term care and home care sectors brought about by the use of combination therapy. "That is why Vice President Gore announced last week a new model program to make this therapy available earlier in the course of infection for Medicaid-eligible individuals with hiv/aids. However, only a small minority of individuals receiving assistance from ADAPs also meet the criteria of medical indigence required by Medicaid," he added.

Reductions in Deaths, Hospital Stays and Costs

Members of the ADAP Working Group and other experts and advocates testified before Congress that:

* In the wake of initial FDA approvals of protease inhibitors in late 1995 and early 1997 (four of these are now available for prescription), the Centers for Disease Control (CDC) mortality reports for the first six months showed a 13% reduction in aids-related deaths, the first drop since the CDC began reporting aids deaths in 1981;

* Three analyses of aids treatment data presented at the 4th Retrovirus Conference in January confirmed unequivocally that combination therapy with protease inhibitors keeps patients healthier, and therefore dramatically cuts the cost of treating aids and hiv;

* The AIDS Center at New York's Saint Vincent's Hospital reported a 24% drop in average monthly hospitalizations of people with hiv and aids, and a 16% drop in average length of stay;

* Towers Infectious Disease Associates, a group medical practice associated with Cedars-Sinai Medical Center in Los Angeles, reported a 57% drop in hospital days utilized per month, a 65% reduction in average days of skilled nursing or hospice care and a 93% reduction in the use of home healthcare services;

* The French Federation of AIDS Centers reported that in the four aids treatment centers in France, where approximately 25% of patients have been shifted to triple combination therapy including protease inhibitors, monthly savings in hospital costs have averaged $650,000.

970601
BA970605

Copyright © 1997 - Beings Alive. Permission granted for noncommercial reproduction, provided that our address and phone number are included if more than short quotations are used. Subscription lists are kept confidential. Being Alive, 621 N. San Vicente Blvd., West Hollywood, CA 90069, Tel - 310.289.2551; FAX - 310.289.9866; Email: BeiAlive@aol.com  http://www.beingalivela.org/