Insurers Picking Up AIDS Drug

In a conference call on first-quarter earnings Tuesday, Trimeris CEO Dani Bolognesi said he is pleased with the progress made so far in persuading health insurers and government agencies to cover the price of Fuzeon, its new AIDS drug. Of the 142 largest insurers, 94 percent -- including Aetna and Cigna -- have agreed to cover Fuzeon, as have Medicaid programs in 48 states. At $19,900 for a year's supply, Fuzeon costs more than twice as much as any other HIV treatment. It was approved by the Food and Drug Administration in March, and distribution began later that same month.

The drug's price -- which Durham, N.C.-based Trimeris and its Swiss partner Roche say is justified by the high cost of manufacturing and by the nearly $600 million spent developing it -- has sparked concerns that cash-strapped state AIDS Drug Assistance Programs, which provide drugs to HIV patients who lack health insurance, would not cover its cost. ADAPs in 13 states, including North Carolina, have had to establish waiting lists or otherwise restrict patients' access to drugs. Roche agreed to deeper than usual discounts on Fuzeon and other medications to ADAPs -- a move that has helped persuade 11 state ADAPs, including North Carolina's, to cover Fuzeon so far. Walter Capone, Trimeris' vice president of commercial operations, said he expects close to half the nation's ADAPs to cover Fuzeon within the next few months.

Steve Sherman, coordinator of North Carolina's ADAP, said there are patients in the state's program who "really need this drug to maintain their health." To contain costs, the program is initially capping at 25 the number of patients who can receive Fuzeon and is limiting the drug to patients not doing well on their current regimens. North Carolina's ADAP had 170 patients on a waiting list in April, but it eliminated the waiting list this month.

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