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Sunday, July 26, 2009

HIV/AIDS and Not Having Health Insurance

By Yao Rien

This is a brief look at what drug prices are at for HIV medications and why our health care system can fall short. This does not only hurt the 40 million in the US without insurance but also those who are under insured.

HIV/AIDS drugs can cost hundreds, even thousands of dollars every month depending on the regimen. A common starting regimen consists of Kaletra boosted by Ritonavir/Lamivudine/Zidovudine. The price of a month's supply for each can be as high as 198.99$, 289.99$, 385.88$, 170.00$. This adds up to more then 1k a month in just medication costs. Other starting regimens including Atripla can be more then 1500$ for a one month supply. So if you have no insurance your total care costs can quickly rise out of your reach with the combination of bills for doctors visits, medication, and time lost not working. You can even just be under insured for medication costing you large copays exceeding 500 dollars a month.

This adds up to more then 1k a month in just medication costs. Other starting regimens including brand Atripla can be more then 1500$ for a one month supply. If you don't have health insurance the cost of your care can exceed your reach with the combination of health related bills. You can simply be under insured for medication costing you copays in excess of 500 dollars a month. These factors can make it very hard for uninsured to pay for their medical bills and not go into debt. In the end this can even compromise health care, and forces patients to go without care.

If you recently were diagnosed with HIV all the new medications and treatment options can overwhelm you. It is critical that you start seeing a HIV specialist as soon as possible. They should take labs immediately to help you start to get a better idea when to start treatment. The NIH did a study and determined the level at which you should begin treatment. Death rates increase if HAART is delayed, started below 0.200 x 10(9) cells/L. Also, nonadherent patients have higher mortality rates than adherent patients with similar CD4+ cell counts.

Also, non adherent patients have higher mortality rates than adherent patients with similar CD4+ cell counts. Above a CD4+ cell count of 0.200 x 10(9) cells/L, medication adherence is the critical determinant of survival, not the CD4+ cell count at which HAART is begun.

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