Don_s_Mohidin@uunet.UU.NET (03/02/90)
The following article, written by Charles Hite, Medical Writer, appeared in
the Roanoke Times & World News on Tuesday February 27, 1990 in Roanoke
Virginia. It was copied, with permission.
-----------------------Article Starts Here------------------------
Support groups assail guidelines for free AIDS drug
By CHARLES HITE
MEDICAL WRITER
Many who could benefit from AZT, an expensive AIDS drug, will be
forced to go without the medication unless state health department
guidelines are relaxed, officials with AIDS support groups say.
"This is going to be a huge problem," said Mary Kelly, case
manager for the AIDS Support Group in Charlottesville.
The department's decision to lower the income level by half for
those who can qualify for free AZT means many people simply will
not be able to afford the drug, which costs at least $3,200 per
year for most people, Kelly said. "It's really criminal."
Health department criteria for people to receive free AZT "don't
make economic sense for the state" because they force working
taxpayers to quit their jobs and end up on welfare, said John
Conley, director of the AIDS Council of Western Virginia.
The guidelines also exclude people who are infected with the
acquired immune deficiency syndrome virus but have yet to show
symptoms of the disease. "Our concern is that AZT has been shown
to alleviate symptoms and delay the onset of the full-blown
disease," said Robert Lawrence, executive director of the
Tidewater AIDS Crisis Taskforce.
Health officials say they would like to open the AZT program to
more people. But restrictions are necessary, they add, in order
to make certain those most in need get the drug.
Federal money for the AZT program ran out Sept. 30. The health
department continued to use stockpiled AZT to serve about 130
people who are enrolled in the program, but new patients were
turned away.
At the end of the year, Congress granted the state $326,000 to
continue the program. To ensure that the AZT program would not
run out of money, the health department cut the maximum income to
be eligible from $22,000 to $11,960.
The General Assembly appears likely to add $1.3 million or more
in state money to supplement the AZT program. Even with the
additional funds, state health officials believe it will be
impossible to relax guidelines enough to make AZT available to all
those who could benefit.
It could cost up to $8 million per year to fund the AZT program
if it were expanded to include people infected with the AIDS virus
who are not showing symptoms, said Dr. Edwin Brown, deputy
commissioner for health care services. That prediction assumes
most of the estimated 15,000 to 20,000 asymptomatic persons
receive treatment.
Health department figures show that of the approximately 200
people now enrolled in the program, about 15 percent would not
have qualified if the lower income limit had been in effect. That
figure, however, was calculated when the AZT was approved for use
only in persons with full-fledged AIDS.
AZT is the only medication licensed for treatment of AIDS, and
its use has been approved only in the sickest patients. But new
research shows that AZT can delay the onset of AIDS in people who
have no symptoms.
Current state guidelines give "some latitude" for some
asymptomatic persons to be given AZT, said Dr. Martin Cader,
director of the division of health department's communicable
disease control. "We've said a person has to be symptomatic, but
we haven't said or defined what these symptoms are," he said.
But there is no latitude in the new income guidelines, meaning
some people are being turned away who once would have qualified.
Tom, a 38-year-old Roanoke office worker, was turned down for
free AZT just last week. He had wanted to get on the program last
fall, but he learned that no new applications were being accepted
until federal money is restored. Over the past few months, he has
spent several hundred dollars of his own to buy AZT and has
borrowed money from an emergency fund at the Roanoke AIDS Project,
one of the support groups in the AIDS Council of Western Virginia.
"I don't fill a lot of prescriptions because of the expense" of
AZT, said Tom, who asked that his last name not be used. Tom said
he has also put off other medical treatment for his AIDS infection
because of the expense.
Conley, the director of the Western Virginia council, said he
knows of at least eight people who have not been able to qualify
for the AZT program because of the new state guidelines.
What disturbs Conley is that people like Tom, who are still
relatively healthy and holding down jobs, will be forced to
impoverish themselves and qualify for Medicaid before they can
receive free AZT.
The state will then lose taxpaying workers and also end up
paying for hospitalization if these people become severely ill,
Conley said.
--------------------------End of Article----------------------------------
John Conley
Roanoke AIDS Project
(703)985-0131
Martin Cader,MD Director
Division of Communicable Disease Control
Virginia Department of Health
Richmond VA 23219
C.M.G. Buttery,MD Commissioner of Health
Virginia Department of Health
Richmond VA 23219
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538 Mountain Ave.,SW employer since I work for myself."
Roanoke, VA 24016 (703)344-5040
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