North Carolina AIDS Program To Limit Fuzeon Access to 25 People
While the North Carolina AIDS Drug Assistance Program will cover the cost of Fuzeon, the group will restrict access to the treatment to 25 patients because of the drug's high cost, the Charlotte Observer reports. The state ADAP, which buys HIV medications for low-income patients, has an enrollment of 2,820 people -- 15% of the state's residents known to have HIV -- and has a budget of $24 million. The income ceiling used in part to determine eligibility for the North Carolina ADAP is the lowest in the nation, according to the Observer. Participation is limited to those who earn no more than $11,225 annually for a single person, or $23,000 for a family of four (Stobbe, Charlotte Observer, 5/31). The FDA in March approved Fuzeon, which is designed for HIV/AIDS patients who have failed to respond to other medications. The drug costs about $20,000 per patient per year, double the price of the most expensive HIV treatments currently on the market. In addition, the total cost of treatment could reach between $30,000 and $40,000 per patient per year because the drug must be taken in combination with other medicines (Kaiser Daily HIV/AIDS Report, 5/15). The North Carolina Medicaid program, along with a majority of private and public insurance plans, said it will pay for the drug. But the North Carolina ADAP will determine eligibility for the drug based on whether patients meet medical criteria and the order in which they sign up for coverage (Charlotte Observer, 5/31).This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.