New AIDS drugs out of reach of many patients

Kate Lowenhar

Monday, Sept. 9, 1996 | 11:59 a.m.

New drugs offer unprecedented hope for treatment of the virus that causes AIDS. But certain AIDS victims in Nevada won't have access to the possibly life-prolonging drugs.

At issue are state AIDS Drug Assistance Programs that provide medication for uninsured individuals who don't qualify for Medicaid. About 400 AIDS victims in Nevada are covered under the program and the demand increases each year.

Protease inhibitors, especially when used in conjunction with other drugs, knock out one of the enzymes that the AIDS virus uses to replicate itself, dramatically reducing the amount of HIV in a person's blood.

Clinical studies still must prove that reducing the amount of virus in the blood actually leads to long-term improvements in the patient's health. But because of the potential advantages of the drugs, many doctors felt that AIDS patients didn't have the luxury of waiting that long.

The three drug cocktails cost a whopping $10,000-$15,000 per person per year, and stopping taking them for even a month can allow HIV to rapidly mutate into a virtually untreatable strain.

Consequently, when the new protease drugs began selling in December, state ADAPs faced a compound problem: how to afford at least one and give it only to patients to whom they could guarantee a constant supply.

Twenty-nine states now offer at least one protease inhibitor.

At a Physicians Advisory Committee meeting Aug. 27, Nevada health officials decided there was not enough money in federal funding to provide the new protease inhibitor drugs.

Instead, the new AIDS formulary includes two reverse transcriptase inhibitors, D4T and 3TC, which are used in conjunction with other AIDS drugs to create potent two- and three-drug combinations.

Some health officials are outraged. According to Dr. Brian Onbirbak, "We cannot afford the protease inhibitor drugs because Nevada does not provide any money for the AIDS Drug Assistance Program."

A representative from the nonprofit Aid for AIDS of Nevada pointed out that the lack of state funding led officials to vote against providing the protease inhibitor drugs because it would mean throwing many patients out of the AIDS Drug Assistance Program.

The state Legislature convenes every two years to discuss issues such as funding for ADAP. The 1997 Legislature will convene in January, and "if we don't approach the Legislature about matching the federal funding for ADAPs, then we're lost for two more years," Onbirbak said. "Otherwise, we won't have the money to provide life-saving protease inhibitors."