Following AIDS advocates' initial euphoria at a new drug approved to treat patients with advanced stages of the disease came their dismay at its expected annual price tag: $20,000.

"This is a bittersweet moment," said Daniel Montoya of AIDS Project Los Angeles. "For people who have no other hope but these drugs, they provide a great amount of promise." But the price, he said, is prohibitive.

Fuzeon, approved Thursday by the U.S. Food and Drug Administration, is the first in a new class of drugs, called fusion inhibitors, that block the virus' ability to infect components of the immune system. Experts estimate about 10 percent of HIV/AIDS patients have virus strains resistant to current drug regimens and could benefit from Fuzeon.

Although the U.S. price for the drug has yet to be determined, Roche Pharmaceuticals has said it will be close to the European price of $20,409 per year.

California health officials said Friday Fuzeon represents the greatest financial challenge to the state's AIDS Drug Assistance Program since the introduction of protease inhibitors and combination therapy in 1995-96. At that time, the cost for many patients doubled while some patients' drug costs jumped as much as fivefold.

At the New York-based AIDS Treatment Data Network, officials feel betrayed. Lei Chou, director of the network's access project, said the company went to great lengths "to convince the community that they're willing to work with us, telling us how they were intending to price this drug as part of a whole chain of research instead of wanting to recoup their investment on this drug alone. Now we see it's about dollars."

Roche spokesperson Heather Van Ness said the company wants everyone who needs Fuzeon to have access to it and emphasized that the $20,000 price reflects the 10 years it took to develop the drug and the $600 million spent on research, clinical trials, manufacturing and other expenses.

Montgomery and officials from five other states are meeting with Roche in Washington today to discuss the drug's cost.

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