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PHOTO: Julie Turkewitz
In the midst of a drug access crisis —the wait list for lifesaving AIDS medications is now just a smidge short of 3,000 people—AHF estimates that these measures will save states an estimated $135 million. (NOTE: Cost-containment measures are being considered in New Jersey.)
“When you go up against a drug company, they usually get what they want,” said Tim Boyd, AHF’s policy research coordinator. “What has been achieved here has been unprecedented.” So in the face of a crisis, pharmaceuticals swing in as white knights. Right?
Not so fast.
Julie Turkewitz
The nation’s state-run AIDS Drug Assistance Programs provide free medications to low and mid-income underinsured individuals. For some, like Karen Bates, a 56-old former paralegal who receives her medications from the S.C. ADAP, the program is a literal lifeline. Lately, ADAPs have been stretched to the financial breaking point, and people with HIV are finding themselves either waiting in desperation to get into a program—or because of budget cuts—kicked off of one.
Why the squeeze? The economic crisis means more people need help paying for drugs. At the same time, states are slashing budgets in every direction. But there’s a third, sometimes conveniently glossed over reason for this crisis: The rising price of AIDS drugs.
Since 1998, the cost of AIDS medications has risen 260 percent, according to a report issued by the Kaiser Family Foundation and the National Alliance of State and Territorial AIDS Directors. Yes, enrollment in state ADAPS also rose in that time period, also stretching state ADAP funds. But by just 137 percent.
ALSO SEE: NJ massive AIDS cuts leave some ‘helpless and homeless’
Consider this: The average introductory price for an AIDS drug released between 1992 and 1996 was just under $4,000, according to this analysis. The average price for a drug released between 2007 and 2010? About $12,000.
It’s no wonder, then, that we’re in this ADAP mess. And these numbers make it difficult to cheer the drug makers, even as they try to help those in need. As Bates said, “They’re not the bad guys, but when you look at the whole picture, they wouldn’t have to gallop in on the white horse to save people who are going to potentially die if the prices weren’t so high.”
Will concessions make an impact?
In the past year, in light of the ADAP crisis, all seven makers of AIDS drugs (Abbott, Gilead, ViiV Healthcare, Merck, Bristol-Myers Squibb, Tibetech and Boehringer Ingelheim) have agreed to some combination of the following, according to Boyd at AHF:
* Increasing rebates given to state ADAPs for HIV/AIDS medications.
* Freezing prices of some medications for a year or more.
* Increasing the number of people who can use assistance programs, also called “compassionate care” programs, that provide medications for free.
* Paying rebates to states up front, thereby freeing up more state money.
Abbott and Merck have gone one step further, agreeing to participate in a special patient assistance program run by the South Carolina nonprofit Welvista. Anyone on an ADAP wait list can sign up by filling out one application—and start receiving Merck and Abbott drugs almost immediately. CLICK HERE TO SIGN UP.
But so far, Welvista’s program provides meds for only about 100 people, according to Ken Trogdon, the organization’s CEO.
While seemingly benevolent, it’s difficult to say whether this program and other concessions make a concrete difference in attacking the swelling ADAP funding problem. Both Abbott and Merck refused to say how much they spend when they provide free drugs through patient assistance programs. What’s clear is that the two are doing pretty well financially: Abbott company sales exceeded expectations recently, jumping nearly 18 percent in the last quarter to $8.826 billion.
Merck predicts its 2010 revenue will exceed $45.4 billion.
“We all live with that fear, the constant fear of ‘How are we going to get our medications tomorrow?’” said Bates. “And it’s scary to think I could be left with nothing but the pharmaceutical companies to help me.”
WANT TO GET INVOLVED?
Julie Turkewitz, a remarkably talented photographer, writer and multi-media artist, writes a blog for Housing Works in New York City, the largest community-based and minority-controlled AIDS service organization in the U.S. Now 20 years old, it saves lives, providing housing, medical and mental health care, meals, job training, drug treatment, HIV prevention education, and social support to more than 20,000 homeless and low-income New Yorkers with HIV and AIDS. To help pay for its services, spread the word of its mission, and employ graduates of its job training program, Housing Works operates a chain of upscale thrift shops, and is probably best known for its tiny Bookstore Café in Soho, just off Houston Street. The literary hub and concert venue draws incredible singers, authors and other artists, all seeking to help Housing Works fulfill its selfless mission.
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