Funding Cuts Soon For Ohio HIV Drug Program

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Many Ohioans living with HIV and AIDS soon could have a tough time getting their life-saving drugs. The problem is not a lack of medications; it’s a lack of funding for drug assistance programs. Federal funding for state drug assistance programs have been flat. Many states like Ohio find they’re running short of money as people requesting assistance increases.

Twenty-five years ago an HIV diagnosis almost always led to AIDS and then death. Scientists, though, developed new medicines that turned a terminal illness into a chronic disease.

But HIV drugs are expensive. They can cost patients tens of thousands of dollars a year. The Columbus AIDS Taskforce helps foot the bills. It gets get reduced rates from drug companies and it gets funds from the Ohio HIV Drug Assistance Program. For many the assistance is literally a life-saver.

But the assistance program is being strained as the number of people using it has doubled since 2005. Right now, there about 5,000 people enrolled in the program with about 100 new people signing up each month.

Jay Carey is an analyst with the ODH’s HIV drug program.

“We cannot continue to sustain our program with that influx of new clients,” Carey said.

So ODH is looking at ways to reduce the number of patients and costs. Some of the changes it’s considering include capping enrollment, reducing the types of drugs it offers and tightening financial eligibility.

“I think the changes that we’re considering at this point will be of a magnitude that probably has not been seen in Ohio,” Carey said.

Ohio is not alone in this. Some states have capped enrollment forcing patients onto waiting lists. Nearly 800 people are waiting for assistance in North Carolina. Other states like Arkansas, North Dakota and Utah have lowered financial eligibility to as low as 200 percent above the Federal Poverty Level.

Ohio has always maintained a high financial eligibility cap 500 percent above the federal poverty level. That means someone making $54,000 can get drug assistance. Of all the cost-saving changes, lowering financial eligibility concerns Peggy Anderson the most. She heads the Columbus AIDS Taskforce.

“I believe that Central Ohio has a significant amount of individuals who will fall within that 200 – 300 percent range, and those are the folks who typically do have a job. Probably a job without insurance or a job that has insurance with a very low medication cap or maybe the co-pays are really high. And so I believe there’s going to be a whole lot of our clients who are working but then are not going to be able to afford their medications,” Anderson said.

Bonnie Baris with The Woodlands in Newark, an HIV/AIDS drug assistance program, has the same fears.

“We’re talking about many, many, many people who will be affected,” Baris said.

The Woodlands serves about 150 clients a year. Baris said if the income limits are raised cases workers could lose up to two-thirds of their patients.

“I think what might happen then is the clients might become more ill, and then perhaps lose their resources and then end up under 200 percent of poverty. It would seem to be a domino effect,” she said.

The ODH’s Jay Carey would not say how far the state is considering raising income eligibility.

“I think it’s safe to say there probably will be a change to that. We’re finalizing those details. And I can’t provide at this time until we do have final decisions made what those will be, but I think it’s safe to say there probably will be a tightening of our financial eligibility,” Carey said.

Ohio gets about $23 million in federal funding a year. The state contributes another $11 million.

Murray Penner is with the National Alliance of State and Territorial AIDS Directors in Washington, D.C. It monitors what states are doing with their drug assistance programs. He said HIV/AIDS funding advocates are asking the government for a $126 million emergency supplement to help maintain programs.

Like, Carey, Penner agrees states cannot continue on the track they’re on. The convergence of more patients, better medicines and a bad economy have in his words created, “The perfect storm coming together to create this environment. And that’s why we just have to have more money to sustain the growth.”

And Penner worries that enrollment caps and reduced eligibility will reverse decades of progress.

“I certainly hate to predict you know that much gloom and doom, but if we continue to see more and more people on these waiting lists, we’re going to see more and more people without access to medications and therefore a return back to older times,” he said.

Peggy Anderson with the Columbus AIDS Taskforce does not want to see treatment go backwards.

“The fact is, without medications people will die. And it happened in the 1980s and 1990s before we had medications. And we need to make sure they stay healthy,” Anderson said.

There are more than 15,000 people living with HIV or AIDS in Ohio.