AIDS Drug Treatment
Programs In Financial Crisis
From Gary North's Y2K Links and Forums
From Allen Comstock

Note - At approximately $75,000 per year per patient for the new multiple drug regimens, it is easy to understand the catastrophic costs of caring for those in need. Multiply the 3 million HIV infected in the U.S. by $75,000 per year...
PHILADELPHIA (Reuters) - A financial crisis in the treatment of AIDS is worsening as new drugs push costs up, and may widen the gap between the resources devoted to fighting AIDS and other diseases, doctors said Thursday. Two Midwestern doctors, writing in a journal published by the American College of Physicians, said government assistance programs for AIDS sufferers have been inundated by demand for services because of the skyrocketing cost of new treatments. As medical innovation continued, drug assistance programs would not meet growing needs without generous funding increases from state and federal governments, they said. But Dr. David Casarett, an internist at the University of Iowa Hospitals and Clinics, said additional funding for AIDS would only add to a growing disparity between resources devoted to fighting AIDS and those directed at other diseases. ``The problem is not that we're treating AIDS too well. The problem is that we're not treating other diseases well enough. What we need to find are ways to make programs for AIDS available to people with other diseases,'' he told Reuters. The article by Casarett and Dr. John Lantos of the MacLean Center for Clinical Medical Ethics at the University of Chicago appeared in the May 1 issue of Annals of Internal Medicine. The doctors described the American experience with AIDS as one of ``economic exceptionalism'' in which government assistance to AIDS sufferers has surpassed that for other major diseases. When the anti-AIDS drug AZT appeared in the 1980s, two-thirds of AIDS sufferers had no health insurance or soon found their insurance benefits limited. The federal government responded with the AIDS Drug Assistance Program (ADAP) which provided AZT to those lacking adequate insurance coverage. The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, which also provides funds for AIDS-related outpatient treatments, was added in 1990. Financial problems began to accelerate with introduction of dramatically more expensive drugs, known as protease inhibitors. Across the United States, state ADAPs saw costs rise as much as 400 percent in the first half of 1996. Because the CARE Act has no entitlement, ADAPS have had no protection from rising costs and many have scaled back by limiting access. Illinois lowered eligibility income limits, for example, while Missouri set caps on individual expenditures and Louisiana created waiting lists for treatment. ``As persons with AIDS look forward to longer survival and improved quality of life, their care will become even more costly,'' the doctors said. They suggested lobbying groups for AIDS and other diseases press for fundamental health-care reforms rather than changes tied to specific diseases. The article highlighted the efforts of the AIDS Coalition to Unleash Power (ACT-UP), which Casarett said favors a system of nationalized health insurance.

Stress Seen Affecting Monkeys' AIDS Survival Rates
DAVIS, Calif. (Reuters) - Monkeys infected with an AIDS-like virus live longer if they are kept in stable social groups, a sign that emotional stress is a factor in the progression of the disease, scientists said Thursday. John Capitanio, a psychologist at the University of California, Davis, said the conclusions of his study on rhesus monkeys indicated that stress levels should be considered when treating human AIDS patients. ``Our data provide strong evidence that such stresses can have an impact on the course of the disease itself,'' Capitanio said. The U.C. Davis study took 18 rhesus monkeys infected simultaneously with the simian immunodeficiency virus (SIV) and placed them into two groups. Both groups were allowed the same amount of ``social time'' with other monkeys each day. But one group was always placed with the same individuals in ``stable'' associations, while the other was placed with a variety of different individuals in ''unstable'' associations. The study found that monkeys in stable groups lived an average of 40 percent longer than those in unstable associations, an average of 588 days compared to 420 days. The researchers said that early measures of infection, including virus levels in the monkeys' blood, also predicted survival rates. While those measures were largely the same for monkeys in both the stable and unstable groups, the study found that in both situations those monkeys that did not ``fit in'' to the social grouping had the worst prognosis. ``The monkeys that received the most aggression from other monkeys had the worst blood-test results,'' the study results said. Capitanio said the study, which appears in the April 14 issue of the journal Proceedings of the National Academy of Sciences, indicated that AIDS-fighting efforts should also take into account socially induced stress.

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