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Sep 24, 2005

I tested positive when the test came out (86?), and have had low <50 t cell counts for about 15 years. I have been injecting luekine 3 x a week for about 6 years. My insurance co. decided my co-pay should be $450 a month, not $35 a month, so I tried doing without it for a month, and got sick. Curiously, there didn't seem to be any difference in my blood work, but i got a lot of skin infections including a big one under my arm and felt tired and lousy. My doctor says there aren't any lower cost drugs that do the same thing. Do you know if it is possible to get luekine in Canada or somewhere else cheaper? Do you know of any other comparable drug? This is a lot of money on top of my $600 monthly insurance payment and $200/mo in drug co-pays. How can anybody afford to live? I just turned 50 and am still working and in OK health otherwise, although I have cycled through all the HIV drugs (except t-20) at least once and am on my 2nd and 3rd go rounds.

Also, what is the difference between luekine and IL-2?


Response from Dr. Young

Al, thanks for your post.

Sorry to hear about your difficulties in getting your medications. Leukine (saragramostim, GM-CSF) is a white blood cell growth factor (monocytes, neutrophils and dentritic cells to be precise) and is approved ("indicated") for use after chemotherapy. It's entirely different than interleukin-2. I'd be curious to know exactly why your doctor has prescribed it for so long. Perhaps because the drug is not being used for an approved indication that your insurance company has increased your copayment; it may be that there are other, "on formulary" drugs that are prefered.

We'd use this type of drug in persons who have chronically, and significantly suppressed levels on one or more of these cell types. Such deficiencies are not all that common among persons with HIV infection. Indeed, the lack of changes in your blood counts on and off Leukine suggests to me that there may not be a whole lot of benefit to you, especially if one figures your cost, not to say anything of the ~$2000/month cost to the insurance company.

So, first off, I'd explore the basis for the need for this medication. Perhaps a lesser expensive growth factor, like Neupogen might fill the need without the additional cost.

I hope this helps, BY

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