MARCH 11, 1994 GAY PEOPLE'S CHRONICLE

HEALTH WATCH

Ways to lower the cost of HIV care

by Dr. Elliot Neufeld and Gary Avis

Getting medical care when you are HIV positive or have AIDS can often be an expensive proposition. The major reasons for this are the cost of drugs and laboratory tests. It is possible to reduce this cost dramatically by knowing where to go for care, what financial assistance programs are available, and what types of information to request from your doctor. There are many ways of cutting the cost of HIV care: ● Enrolling in a clinical trial. Many of the standard drugs used to treat HIV and its related infections are being tested in clinical trials.

Using financial assistance programs of drug companies.

The state government HIV drug program. • Obtaining direct patient assistance through the Ryan White program.

Obtaining an AIDS waiver from Medicaid.

● Comparison shopping.

Clinical trials

This method can enable you to cut costs in two ways. First, if you enroll in a trial that is testing one of the drugs you need, you will be provided the medication for free. Also, in order to determine the effectiveness of the medication, many lab tests are done. These can be provided to your primary care physician if you sign a release authorizing it. This will reduce the expense of duplicate lab tests. By enrolling in the cohort study (which is now used for screening of people enrolling in clinical trials) lab work will be done prior to your enrollment in a trial.

For more information on clinical trials at University Hospitals, call 844-8175; or call MetroHealth Hospital at 459-5156. The Medical College of Ohio in Toledo also has trials; call 419-381-3741.

Drug company financial assistance programs

Many drug companies have financial assistance programs. The requirements may vary and the programs may only be available for a short time, but this can be a good option. At top right is a list of drugs, infections they are used to treat, and who to contact. Generally, it is best for your family physician to contact these companies for you. Please note that the availability for these programs can change at any time.

In some cases experimental drugs may be available at little or no cost on a compassionate use (also known as either treatment IND—investigational new drug—or Expanded Access) protocol. These protocols, listed in the box at bottom right, are designed for people who do not qualify for a clinical trial but who have failed all other available therapies.

State HIV drug program

Ohio has an HIV program which can provide eight FDA-approved drugs for those who financially qualify. To qualify, you must have a CD4+ count less that 500, be an Ohio resident, have a monthly income less than $1,302 after taxes (with an additional allowance for dependents), and submit a physician certification of HIV infection. You must not be receiving assistance through other government programs such as Medicaid or general assistance-medical or have health insurance that will cover the cost of the drugs. The available drugs are:

Acyclovir (Zovirax)

Aerosol and intravenous pentamidine Dapsone

ddC (Hivid)

ddI (Videx)

Fluconazole (Diflucan)

Retrovir (AZT, zidovudine) TMP/SMX (Bactrim)

For further information, call or write: HIV Drug Program Coordinator, AIDS Activities Unit, Ohio Department of Health, P.O. Box 118, Columbus, OH 43266-0118; 614-466-6669.

Ryan White funds

Money for HIV drugs or care may also be available through the federal Ryan White Act. Contact your case manager at the Health Issues Taskforce, 621-0766, to see if you qualify for these funds.

Cleveland Free Clinic

The Free Clinic of Greater Cleveland has an AIDS Early Intervention Program that offers a treatment program for people with HIV or AIDS. Call 721-1115.

Medicaid AIDS waiver

If it is determined that you are in the late stages of HIV infection, you may qualify for a Medicaid AIDS waiver. This waiver will provide additional money to you for care and HIV drugs.

Comparison shopping

Some pharmaceutical providers such as Statlander's (800-238-7828) or the Community Prescription Service (800-842-0502) will accept your insurance coverage for drugs as payment in full. What this means is that if your insurance only pays 80 percent of the drug cost, they will accept that as payment in full and subsequently will not require you to pay the other 20 percent.

In order to reduce the cost of HIV care, it is important to use a team approach. This means letting your physician know what your financial situation is so that the two of you can develop a treatment plan that can reduce costs for you.

COMMUNITY FORUM

Continued from facing page

Friendly follow-up

To the Editors:

Just a friendly follow-up to my "Pure caca" letter's printing and the timely writing of K. Dagg's long-questioning "divide-anddestroy strategy" letter [February 25].

I felt somewhat miffed at thinking that my message about effective presence could be watered down potentially by Dagg's belly-aching about my belly-aching. Ah, but we must let the letters fall as they may, mustn't we?

As a close to my initial sentiment, may I have the opportunity to call for help from K. Dagg sometime this year should I be allowed to position myself again as Pride's Volunteer Coordinator.

By virtue of community groups making the effort to ask for support, it seems as if K.

Dagg believes that these groups are entitled to same. So be it. May we see you all at the next Pride Committee planning meeting! S.K. Bair Pride '93 Volunteer Coordinator Garden Party IV volunteer past Womyn's Variety Show volunteer past Happy Feet party volunteer

Community Forum

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not to.

Address letters to the Chronicle, P.O. Box 5426, Cleveland, Ohio, 44101, or fax to 216621-5282 (24 hours). Include your address and phone number so we may contact you to verify the letter.

Financial assistance

Drug Acyclovir (Zovirax) Aerosol pentamidine (Nebupent)

Alpha interferon (Roferon-A) Alpha interferon 2B (Intron-A) Atovaquone (Mepron) Azithromycin

AZT (Retrovir, zidovudine) Bactrim (TMP/SMX)

Infection Anti-herpetic Pneumocystis carinii

pneumonia (PCP)

Kaposi's sarcoma

PCP

Toxoplasmosis, M. avium,

cryptosporidiosis

HIV

PCP

Ciprofloxacin (Cipro)

Mycobacterium avium

complex (MAC)

Clarithromycin (Biaxin)

MAC

ddC (Hivid)

HIV

ddl (Videx)

HIV

Dronabinol (Marinol) EPO (Procrit)

Wasting syndrome Anemia

Fluconazole (Diflucan)

Foscarnet (Foscavir) G-CSF (Neupogen) GM-CSF (Leukine)

Gancyclovir (Cytovene) Intraconazole Liposomal daunorubicin Megastrol acetate (Megace)

Octeotide acetate (Sandostatin)

Prokine

Pyrimethamine (Daraprim) Rifabutin

Septra (TMP/SMX)

Cryptococcosis, candidiasis Cytomegalovirus (CMV) Neutropenia Neutropenia

Cytomegalovirus (CMV) Histoplasmosis Kaposi's sarcoma Wasting, weight loss

Cryptospordiosis,

HIV-related diarrhea Neutropenia Toxoplasmosis MAC prophylaxis

PCP

Contact

Burroughs-Wellcome, 800-722-9292 Fujisawa, 800-366-6323

Hoffman-Laroche, 800-443-6676 Schering, 800-521-7157

Burroughs-Wellcome, 800-722-9294 Pfizer, 203-441-5941

Burroughs-Wellcome, 800-722-9292 Hoffman-LaRoche, 800-526-6367 #21 (physicians only)

Miles Pharmaceutical, Indigent Patient Program, 800-998-9180 Abbott, 800-688-9118 Hoffman-LaRoche, 800-285-4484 Bristol-Myers Squibb, 800-788-0123 Roxane Labs, 800-274-8651

Ortho, 800-447-3437

Pfizer, 800-869-9979

Astra, 800-488-3247

Amgen, 800-272-9376 Immunex, 800-334-6273 (physicians only) Syntex, 800-444-4200 Janssen, 800-544-2987 Vestar, 800-247-3303 Bristol-Myers, Megace Temporary Assist Program, 800-788-0123 Sandoz, Indigent Patient Program, Project Nord, 800-447-6673 Hoechst, 800-776-5463 Burroughs-Wellcome, 800-722-9292 Adria Labs, 800-795-9759

(physicians only)

Burroughs-Wellcome, 800-722-9292

Treatment INDs

Drug Albendazole

d4T

(Stavudine) Diclazuril Trimetrexate

Infection Microsporidiosis

HIV

Cryptosporidiosis

PCP

Sulfadiazine

Acute toxoplasmosis

Fluconazole

Acyclovir-resistant, muco-

cutaneous herpes simplex

Availability

Case by case

For intolerance to or failing other therapies

For intolerance to both TMP/SMX

and pentamidine

Contact SmithKline Beecham, 800-877-7074 Bristol-Myers Squibb, 800-842-8036

Janssen, 800-521-2437 U.S. Bioscience, Jennifer Nutter, 800-537-9978

CDC Sulfadiazine

Release Ctr. (physicians

only), 404-488-4928

Astra, 800-388-4148

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