October 27, 2006
Benjamin Linas of the Harvard Center for AIDS Research, Massachusetts General Hospital and Harvard Medical School and colleagues examined if AIDS Drug Assistance Programs would be more efficient if they prioritized clients based on CD4+ T cell counts rather than operating on a standard "first-come, first-served basis." The researchers used Massachusetts ADAP administrative figures to develop a retrospective study of the state's ADAP clients from fiscal year 2003. They compared the characteristics of patients included under CD4+ T cell count-based eligibility criteria with the first-come, first-served eligibility criteria. The study found that Massachusetts ADAP -- which during FY 2003 served 3,560 clients at a cost of $10.3 million -- would have served 2,253 clients using CD4+ T cell count-based model and saved $2.7 million during the same time period. Given the same budget limitations and using the first-come, first-served eligibility, Massachusetts ADAP would have served 2,406 clients. The study also found that the first-come, first-served model would have excluded patients with a median CD4+ T cell count of 659 in favor of serving patients with a median CD4+ T cell count of 257. A CD4+ T cell count-based approach also would have served 65% of nonwhite clients, compared with 55% of whites. Researchers concluded that ADAPs with limited resources will "serve more diverse populations and patients with significantly more advanced HIV disease by using CD4[+ T] cell count-based enrollment criteria rather than a first-come, first-served approach" (Linas et al., Clinical Infectious Diseases, 10/17).
Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily HIV/AIDS Report, search the archives, or sign up for email delivery at www.kaisernetwork.org/dailyreports/hiv. The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service of the Kaiser Family Foundation, by The Advisory Board Company. © 2006 by The Advisory Board Company and Kaiser Family Foundation. All rights reserved.