D.C. Delays OK on Last-Resort AIDS Drug

The Drug Advisory Committee for the D.C. HIV/AIDS Administration decided in May to recommend that the city delay AIDS Drug Assistance Program subsidies for low-income HIV/AIDS patients for the drug Fuzeon, two members of the committee said. HAA, which makes the final decision on whether to accept drugs into the program, traditionally has followed the recommendations of the advisory committee.

Advisory members Rick Elion and Ron Mealy said most panel members believe they need more information on the impact of Fuzeon's high cost on ADAP before recommending its approval. The two said they are leaning toward approval of Fuzeon once they are assured it would not lead to ADAP's bankruptcy.

But some AIDS activists said the city has enough money to support the new drug and the panel should have moved quickly to approve it. "People are going to die while they drag their feet," said Wayne Turner, head of ACT UP/D.C.

Roche, Fuzeon's manufacturer, has announced it would provide the drug -- normally costing $20,000 per patient per year -- to ADAP for $16,000 per patient per year -- a price that is still nearly twice as high as the next most expensive AIDS drug.

"We first looked at it and developed a pre-authorization approach," said Elion. "But we decided we should find out what next year's [ADAP] budget would be. We did not want to approve it and then have to cut off people already in the program." Mealy said he urged the committee to gather more information on the number of people who would likely benefit from Fuzeon in the District. "I'd like to see an analysis," said Mealy.

Because the committee usually meets only four times a year, it was not expected to resume its discussion on Fuzeon until August.

Joy Maatman, a representative with Roche, said that HAA official Carolyn Rachel sent her an e-mail stating that HAA had chosen not to approve Fuzeon for ADAP "at the present time." But Ivan Torres, HAA's acting administrator, said HAA is awaiting the final recommendation of its advisory committee. "We have not finalized our decision," Torres said.

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