- 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...
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- 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.
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- Stress Seen Affecting Monkeys' AIDS Survival
Rates
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- 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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