Bulletin of Experimental Treatments for AIDS, No. 26 September 1995
Ronald Baker, PhD

Under the new policy (scheduled for implementation in September 1995) treatment for CMV retinitis with IV foscarnet will be covered but treatment with IV ganciclovir will not be covered. Some AIDS groups are concerned that people with AIDS on Medicare who are using IV ganciclovir to treat CMV retinitis will be denied this therapeutic option in the future. Yet the drug is arguably the treatment of choice for CMV retinitis induction therapy. Foscarnet is generally considered a more toxic drug (primarily kidney toxicity) than ganciclovir (primarily granulocytopenia and thrombocytopenia). In addition, the costs for treatment with IV foscarnet are about double that for IV ganciclovir.

Like IV ganciclovir, IV acyclovir will not be covered by Medicare under the new guidelines. IV acyclovir is the standard therapy for disseminated herpes simplex infection among people with AIDS.

If you are concerned about the proposed changes to Medi-care policy that would deny coverage for IV treatment with ganciclovir, acyclovir and vancomycin, call 1-800-842-2563 to obtain the toll-free telephone number of the DMERC in your geographical area.

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