The national HIV Medicine Association this week sent Mississippi governor Haley Barbour a letter expressing concern that changes to the state Medicaid program--effective July 1--could put HIV patients at risk and violate federal law. Earlier this year Mississippi lawmakers approved cost-saving changes that would permit Medicaid beneficiaries to receive five prescriptions per month: two brand-name and three generic. The problem is that antiretroviral drugs are brand-name, and HIV patients need at least three to suppress the disease, doctors said.
"We've never seen anything like this before," said HIVMA executive director Christine Lubinski, noting the limit would not allow doctors to prescribe standard antiretroviral therapy. "We're actually right now trying to get in touch with health care advocates in the state to find out if there's a plan to challenge this particular policy," she said, adding that HIVMA may seek legal action itself. Barbour said he has not seen the letter and declined to comment.
The state's "two brand-name prescription drug limit leaves Mississippi's poorest and sickest residents with no option other than substandard HIV care," states HIVMA's letter, which Lubinski said was also sent to U.S. Department of Health and Human Services secretary Michael Leavitt and other officials. "Substandard care for people with AIDS has deadly consequences," it warns. No generic antiretroviral drugs are available nor will they be in the foreseeable future, HIVMA said.
An exemption to the prescription limit could be extended to beneficiaries under age 21, said Francis Rullan, a Mississippi Medicaid spokesman. Rullan could not say how many of the state's 780,000 Medicaid recipients were HIV patients.
Many HIV-positive beneficiaries do not know about the prescription changes, said Harold Henderson, an HIVMA member and University of Mississippi Medical Center infectious disease specialist who treats 1,300 HIV patients. (AP)