ROBERT SIEGEL, host:
Thousands of HIV/AIDS patients around the country are waiting for assistance to pay for medicines that keep them alive. The pileup is due to a convergence of factors, starting with the economy. Many have lost jobs and can no longer afford the drugs.
And as NPR's Brenda Wilson reports, federal and state budgets are not keeping up with their needs.
BRENDA WILSON: A month ago, Florida didn't have a waiting list for ADAP, as the AIDS Drug Assistance Program is called. Now, there are more than 500 people waiting for help in paying for medications.
Tom Liberti, the director of the state's AIDS program, saw the line forming long before it got to this point.
Mr. TOM LIBERTI (Chief, Bureau of HIV/AIDS): Over the last several months in the latter parts of this recession, we have been averaging over 350 patients a month coming forward for assistance.
WILSON: There are about a million and a half unemployed in the state, adding to an already large uninsured population of more than three million. The economic crunch, Liberti notes, has occurred in the middle of a federal government push for states to test millions of people for HIV and get people into treatment early.
Mr. LIBERTI: So if you saw a picture of this, you would see that the demand and the number of patients coming forward has gone up dramatically, but the funding that pays for the pharmaceuticals and the drugs did not.
WILSON: ADAP provides assistance for nearly 170,000 people nationwide who can't afford the expensive AIDS drugs, even on a working person's salary. The drugs can mean surviving many years and leading a productive life.
Federal and state ADAP budgets are determined on a year-to-year basis and haven't changed recently. More than 2,000 people in 12 states are now on waiting lists, and just as many states have tightened requirements for those they will assist.
None of this was on 46-year-old Mike Demory's mind in December when he moved to Victor, Montana from Portland, Oregon. Back in Oregon, his medicines and part of his insurance premium were paid for by Oregon's ADAP.
Mr. MIKE DEMORY: I moved here for my mother. My mother has a lot of health problems and I didn't do much investigating as far as what they had, as far as plans for medication, plans for medical treatment, et cetera, et cetera.
WILSON: First, there was a month-long wait to see a doctor.
Mr. DEMORY: By the time I got in to see the doctor, I had been without my medication for a month and a half, which is bad for somebody on HIV.
WILSON: During that time, the virus started coming back, but he had to get in line behind 18 people who were on a list that he has slowly, month by month, been working his way to the top of.
Luckily, he still had a one-month refill back at the pharmacy in Oregon that was sent to him by mail. And a case manager in Montana helped him apply for free drugs from pharmaceutical companies through the patients' assistance programs that most have.
Mr. DEMORY: So that's three application forms, because each one of my medications are manufactured by a different manufacturer.
WILSON: And every 90 days, he has to reapply for assistance to each of these companies.
Waiting lists for ADAP aren't new. It's been running over budget since a decade after its inception, but never have the lines been this long.
Murray Penner of the National Association of State and Territorial AIDS Directors says it's not just the economy.
Mr. MURRAY PENNER (Deputy Director, National Alliance of State and Territorial AIDS Directors): The other factor driving that is just more people living longer, which is the obvious, and we know that's a good thing over time. But it's something that has been coming over a long period of time since all the new treatments have come into play.
WILSON: In the past, federal and state governments have come up with the emergency assistance. But this time, Penner says Congress has failed to respond to an appeal from the states for $126 million.
Mr. PENNER: Everybody is supportive. I mean, we've got letters with lots of sign-ons from, you know, representatives and senators that's saying, sure, we want more money. But nobody is willing to stick their neck out and actually put more money towards the issue.
WILSON: So state AIDS directors like Florida's Tom Liberti say they're just hanging on until the next fiscal year.
Mr. LIBERTI: We don't want people to panic. We don't want people to make wrong decisions about getting tested or coming forward. I do believe that if the economy gets better and some additional federal resources come through, that we can get by this. Just - it's unclear on how long.
WILSON: Under the new health care law, most of these people would be eligible for treatment, but that won't kick in for another four years.
Brenda Wilson, NPR News.
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