New Mexico HIV
patient challenges Medicare drug denial

An HIV-positive women in Albuquerque has filed a federal lawsuit against several U.S. officials in an effort to get the new Medicare prescription drug plan to cover the antinausea medication her doctors say keeps her alive, The Albuquerque Journal reports. Catherine E. DeBonet filed suit against Centers for Medicare and Medicaid Services administrator Mark McClellan, Health and Human Services secretary Michael Leavitt, and UnitedHealth Group, which handles DeBonet's Medicare coverage. UnitedHealth denied DeBonet's request for the antinausea drug Zofran because the Food and Drug Administration has approved it for use only 12 times monthly and DeBonet's doctors say she needs to take it three times per day. The high dosage of the drug is the only way to treat nausea caused by her antiretroviral drug therapy; without the Zofran, DeBonet is unable to eat at all, her doctors have told UnitedHealth.

DeBonet's lawsuit says that without the Zofran she will required to have a permanent feeding tube inserted into her body, which will raise her risk of pain, infection, and possibly even serious complications.

The New York Times reported in February that many HIV patients around the country are having problems with the new Medicare drug benefit. Cumbersome preauthorization requirements and piles of paperwork for doctors have resulted in delays or even the prevention of access to needed medications. Some participating programs can have as many as 30 preauthorization forms for certain drugs. (The Advocate)