August 29, 2003
Thousands of kilos of the new AIDS drug Fuzeon (T-20) leave Roche Colorado's Boulder manufacturing plant each month, headed for clinics worldwide. But many AIDS patients with HIV resistant to older drugs go without T-20 because it is too expensive. The slumping economy has drained government-funded drug assistance programs and left patients in more fragile condition, said Dr. Joshua Blum, at Denver Health's HIV early-intervention services clinic. He knows of only one patient of the 400 his clinic treats who has been able to get Fuzeon.
Even if the supply increases, state drug programs are losing money and cannot afford the bill, said Blum. Colorado's AIDS Drug Assistance Program, which serves 800 people a month, anticipates a $500,000 shortfall this year. This year is the first in which Colorado has had to limit enrollment, and 80 people remain on a waiting list. Colorado is one of 14 states that have capped enrollment in the programs, started waiting lists, or cut back on providing drugs.
The state's Medicaid program covers Fuzeon but will likely require prior authorization before patients can get the drug, said Karen Reinertson, executive director of the Colorado Department of Health Care Policy and Financing. Though most private insurance covers Fuzeon, it often does not cover the entire cost, Colorado AIDS Project spokesperson Jacqueline Long said. For costs that are not covered, patients turn to the state ADAP.
Unlike current AIDS drugs that attack HIV after it has infected a patient's cells, Fuzeon blocks HIV from entering the cells, disrupting HIV's mechanism for living in the body. A one-year supply of Fuzeon costs $20,000 and must be taken in combination with other medications, boosting the drugs' price for some patients to $30,000 or more.