California: Tighter Controls Set for AIDS Drug

In order to curb abuses -- including a black market among bodybuilders -- California officials said Thursday they will tighten controls on an expensive AIDS drug that cost the state's health program for the poor more than $175 million during the past four years. Starting June 1, new prescriptions for the anti-wasting drug Serostim must be state-approved prior to being filled. Initial prescriptions for the drug, which costs up to $7,000 a month, will be limited to four weeks. The move is expected to save around $7.5 million a year from the state's steadily increasing $3 billion drug tab.

State restrictions on Serostim, a human growth hormone that helps build muscle mass, were so lax that last year Medi-Cal spent more on it than did New York, Florida and Texas combined. Patients currently can receive up to three months' worth of Serostim with only a doctor's prescription and no state approval.

The Los Angeles Times in February reported that California's Department of Health Services does not maintain the same tight grip on Serostim as other large states do. The state's smaller AIDS Drug Assistance Program -- for those who do not qualify for Medi-Cal -- already requires prior approval. "Certainly the article got our attention," said Stan Rosenstein, state deputy health director for medical care services. Rosenstein said concerns about fraud, budgetary considerations and a desire for consistent state regulations all contributed to the decision.

State officials began slowly adding controls a few years ago but resisted a prior-authorization requirement out of fear that it would hinder patient access to the drug. AIDS Health Care Foundation Executive Director Michael Weinstein lauded the administration of Gov. Gray Davis for its response in an era of threatened health care cuts. David Pieribone, associate director for education at AIDS Project LA, said that while tighter controls were necessary to stop abuse, close monitoring by the state is needed to ensure that deserving patients receive the drug.

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