The New Hampshire AIDS Drug Assistance Program's 331 clients received letters last fall stating that they would continue to receive anti-HIV drugs, but expensive medications to fight side effects and other complications would no longer be covered. Last year the federal government cut the state's ADAP grant by 5%, while drug costs leapt by 47% to some $9,300 per patient annually. By December, New Hampshire's ADAP will be nearly $1.8 million in the red.
"That's a recipe for disaster," says William Kassler, state medical director. With possible federal budget tightening and continued drug price increases, things could get worse, he adds. Even some drugs that have been on the market for years are suddenly more expensive. "The drug companies feel that the market will bear this," says Kassler. "They can charge that, and people have no option but to pay."
Kassler's most difficult decision was related to the expensive, last-line anti-HIV drug Fuzeon, which the state can afford for only two patients. There is already one patient on the Fuzeon waiting list. "It's an ethical conundrum," says Kassler. "How can you look this guy in the face and say, we can't give you this medication? But how can you look at other folks and say, we can't give you your medication [because Fuzeon is so expensive]?"
ADAP clients say lobbying lawmakers for more federal funds is hard when the state contributes none of its own funds. However, Gov. John Lynch has included $180,000 for ADAP in his proposed budget. Additionally, state legislators are considering creating a committee to assess the needs of the state's HIV-positive residents. (AP)