AIDS drug program funding enhanced

Two hundred seventy-seven low-income Georgians with HIV/AIDS will gain access to necessary drugs through a government program infused with $3 million in federal dollars to alleviate the program’s wait list.

The funding is roughly four times more than Georgia received last year, and reflects a growing crisis facing states with wait lists for drug-assistance programs that expand as more Americans lose their jobs and insurance.

Georgia’s 1,427-person wait list for the AIDS Drug Assistance Program is second in the country only to Florida, which has 3,335, according to the National Alliance of State and Territorial AIDS Directors. Eleven states have waiting lists totaling more than 6,800 people.

“This really is a crisis facing the HIV community,” said Jeff Graham, executive director of Georgia Equality, a lesbian, gay, bisexual and transgender advocacy group.

Georgia’s drug-assistance program, which serves more than 3,300 people, jumped significantly because of the bad economy plus a push to get more people tested and into early treatment, Graham said.

The wait list allows Georgia to track ongoing assistance needs and cite them when seeking more federal funding, said Dr. Brenda Fitzgerald, who heads the state Department of Public Health. Ninety-nine percent of people on the list receive medications through pharmaceutical company assistance programs, Fitzgerald said.

Despite the additional money, the department estimates it would cost nearly $15.5 million to move everyone off the wait list, which began last year in July. The program's budget for fiscal 2012 totals $53.5 million with state dollars accounting for roughly 30 percent. Yearly treatment costs $10,800 for each patient.

The state needs to look at ways to stretch those dollars, such as using drug-assistance funds for those who also qualify for Medicare Part D to pay out-of-pocket costs, Graham said. If people don't receive the drugs, leading to deteriorating health and hospitalization, health care costs can jump by tens of thousands of dollars, Graham said.

"We want to explore every single opportunity we can," said Dr. Patrick O'Neal, the public health department's director of health protection.

Earlier this year, the state launched a pilot program to move people onto the pre-existing condition insurance plan created under the new health law, an effort that has shown good progress in states such as Arizona, O'Neal said. Georgia is trying to alert case managers about the program, said Fitzgerald, who hopes 300 or more people can be moved over. In addition to paying insurance premiums, state funds can also be used for co-pays and other out-of-pocket expenses.

"Not only are people covered for their medications, but they're also covered for insurance," she said.

AID Gwinnett successfully moved six of 10 people into the program under the pilot project, though some failed to fill out paperwork, said executive director Larry Lehman, who added, "I think it is a learning curve for patients."

The Infectious Disease Program at Grady Memorial Hospital been dependent on help from pharmaceutical companies, said Wendy Armstrong, the program's medical director and associate professor of medicine at Emory University. But the wait list grows every month and there’s concern over how long companies will continue to help, Armstrong said.

“We’re terrified,” she said. “I’m sure they did not expect to be financing that number of people indefinitely.”

As Georgia's largest provider of AIDS care, the Grady program sees 5,000-plus patients yearly. Nearly 690 patients are on the wait list, and an estimated 200 will get slots, she said.

The challenges are that even insured people may have trouble paying high deductibles or have plans that don’t cover medications, Armstrong said. For example, the partner and child for one patient aren’t recognized as dependents, making that man's $30,000 salary too high to qualify him for government or pharmaceutical company assistance programs.

“We can not find a way to get him meds,” Armstrong said. “It’s horrifying.”