The Kentucky Department for Public Health on Monday said it has eliminated a waiting list for the Kentucky AIDS Drugs Assistance Program, which provides life-saving medicine for low-income patients.
Program efficiencies, pharmaceutical rebates and supplemental federal funding allowed the state to begin serving 306 AIDS and HIV patients who were on the waiting list in September, the department said in a statement.
A year ago, Kentucky's program had the nation's longest waiting list.
"This is another step forward in our work to assist Kentuckians living with HIV/AIDS," Public Health Commissioner William Hacker said. "Many Kentuckians rely on this program for assistance in obtaining medications that are absolutely vital for their health."
Sigga Jagne, the state's HIV/AIDS program manager, said the state was able to get rid of the waiting list with the help of a one-time federal supplement of $1.7 million and by cutting about $1.4 million in costs. That was achieved by measures that included using some generics rather than name brands, lowering the dispensing fee pharmacies receive when they fill clients' prescriptions, and removing drugs from the formulary that patients can get through other pharmaceutical assistance programs.
The program's budget for this fiscal year is $12.5 million, Jagne said. Most of that comes from federal coffers and rebates distributed by pharmaceutical companies.
The state started the waiting list in June 2009 because of concerns that there would not be enough money to cover drug costs if new people were added, Jagne said.
Taking people off their medicines once they begin treatment can cause serious problems. The list alleviated fears that people already in the program wouldn't be able to get their prescriptions if the money ran out.
The economic downturn has resulted in more people seeking help from the program, which is considered the "payer of last resort," Jagne said.
Some of the patients work but do not have enough insurance to cover the cost of their drugs; others are on Medicaid but can't afford the co-pays, she said.
The drugs cost an average of $8,500 a person a year, making them too costly for people who already have trouble paying their bills, Jagne said.
Including the new clients added when the waiting list was eliminated, the program provides medicines for nearly 1,500 Kentuckians.
That's double the number it cared for five years ago, said Dr. Kraig Humbaugh, the state epidemiologist.
Other states also are having trouble keeping up with the costs, Jagne said. Nine states have waiting lists for their AIDS drug assistance programs, with 4,369 people waiting for help, according to the National Alliance of State and Territorial AIDS Directors.
About 20 new people apply to Kentucky's program each month, Jagne said.
Assuming that continues, the state should be able to cover the costs for new applicants through fiscal year 2012, Humbaugh said. But he said maintaining the program without a waiting list is expected to be an ongoing challenge.
"It's definitely a major feat to be able to eliminate it," Jagne said.