State eliminates waiting list for HIV medication

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HIV in US West Virginia has been able to eliminate its waiting list for free life-saving drugs for people infected with HIV.

That's progress well beyond that in many other states. In South Carolina, for example, more than 350 poor people infected with HIV are on a waiting list for the drugs. That's the longest such list in the country.

West Virginia's AIDS Drug Assistance Program was able to get rid of the waiting list earlier this fall, thanks to Medicare Part D coverage and state funds.

"Right now, we have a staff of case managers that work at Title III clinics at Charleston Area Medical Center, West Virginia University and other access points," said Jay Adams, HIV care coordinator for the state's division of surveillance and disease control.

"If someone infected needs drugs, now they fill out an application and usually receive the drugs within four days."

Officials managed to eliminate the list earlier this fall through savings they garnered through the use of Medicare Part D. The program required that if an individual was eligible or qualified for Medicare Part D, that it be used as the primary form of payment. The drug assistance program was then used as a secondary form of payment.

"There were some patients that we might have been paying $1,300 for. Then, after the Medicare Part D, we only had to pay $60 for them. It provided us with significant savings," Adams said.

Funds from the state Legislature also helped to eliminate the program's waiting list. Adams could not say how much the state provided the program in funds.

In South Carolina, the waiting list for drugs is much longer and the state Legislature's contribution to the drug program is relatively small.

State officials there said in a recent New York Times article that it would cost South Carolina $3 million to clear the waiting list.

West Virginia's list was in operation since February 2003. It officially ended July 2006, but those on the waiting list were not removed until late August and September.

At one point, more than 40 people were on the waiting list, sometimes less. That number tended to fluctuate, Adams said.

Those on the waiting list, hoping for specific medications on the program's formulary, managed to receive some drugs to help treat the disease while waiting for the antiretroviral drugs.

"Our staff worked very diligently to make sure those people waiting got their medications and didn't go without them," Adams said.

"I wouldn't have been able to sleep at night if they didn't."

According to the Web site www.statehealthfacts.org, the estimated number of people living with AIDS in West Virginia at the end of 2005 was 701, compared to 437,982 nationwide.

The reported number of AIDS cases in the state, cumulative through December 2005, was 1,444, compared to 956,019 nationwide.

According to the Web site, the Mountain State's AIDS case rate is 4.1, compared to 14.0 nationwide.

The AIDS case rate is calculated by dividing the number of AIDS cases reported during the 12 months of the most recent year for which data is available by the population in that same year, multiplied by 100,000.

In 2005, the number of new AIDS cases reported was 47, compared to 41,993 nationwide.

"West Virginia is considered a low incidence state," Adams said. The state normally is ranked in the 30-40 range, out of the 50 states.

In addition to eliminating its waiting list, the state program also has managed to add six drugs to the program's formulary or drug list.

Two of the drugs, Aptivus and Fuzeon, are popular anti-HIV therapies not previously listed on the formulary.

"Those two were certainly in demand, and we finally got them," Adams said.

The two drugs work in combination with other drugs as part of a "drug cocktail" for HIV and AIDS patients.

"Most patients take a combination of three antiretrovirals and other medications," Adams said. "These two work to suppress the virus, allowing the immune system to recover and the disease to slow or stop."

Those infected with the disease and need assistance in getting medications can call (800) 434-9443, access code 44, or directly at (304) 232-6822.

For more information on HIV or AIDS or the drug assistance program, visit www.wvdhrr.org and click on the HIV/AIDS link.

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