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No insurance, not eligible for State Drug Assistance Program
Feb 5, 2005

I have been HIV positive for 7 years, and I was stupid enough not to get helath insurance when I still could have gotten one (I live in Louisiana).

I have been recieving medication trhoriugh the Louisiana State Drug Assistance Program (LDAP), but I was recently rescreened and my income was deememd too high to meet the eligibility criteria.

I, however, can barely make ends meet, and have now been without medication for 7 days.

What are my options? I canno't simply afford to buy the medicine, and due to Louisiana laws, the insurance companies will just simply not take me.

Are there any options? I am very desperate.

Mark R.

Response from Dr. Young

Mark- Sorry to hear of your situation. I suppose that yours is a reminder to have medical insurance in the US, whenever possible.

HIV medications are very expensive (our readers certainly don't need to be reminded of this fact) and for the majority of patients, there are a variety of insurance-based and non-insurance-based strategies to get medications. For those who fall between the insured-well and the employed, but uninsured (or the ill and qualify for governmental assistance programs, like Medicare), AIDS Drug Assistance Programs (ADAPs) frequently (as LADAP did for you) fill in the gap. In recent years, an increasing number of state-run ADAPs have reached the financial breaking point, resulting in cutbacks, eligibility rechecks and frank waitlists. I'm sorry to hear that you've been hit by one of these.

For patients like you, the remedy is not always straightforward-- sometimes the pharmaceutical companies' patient assistance programs can help, though it may be that you make too much money for eligibility. Some patients may qualify for clinical trials that can provide medications (and HIV-related follow up lab work) at no cost. Some communities have "drug banks" that can provide medications to patients for short-term shortages.

I don't know what your current CD4 count is, nor your CD4 count nadir, but it's not impossible to take a treatment holiday-- at least until you can secure health insurance. Talk to your doctor about this possibility. I'd also advise you to contact your local AIDS service oraganization ( check out ASOfinder.com) for counsel about the specific programs in Louisiana.

Lastly, to our readers, please write to your congressional representatives and encourage them to support funding for ADAP (at check out congress.org). One US senator told me last year, "Doctor Young, you should be happy for what your HIV patients receive from the goverment-- they already receive more than they deserve." In a time of increasing financial constraints, without community support, the apparent luxury of governmental drug support will probably not be guaranteed. BY



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