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Public Financing and Delivery of Hiv/Aids Care: Securing the Legacy of Ryan White
Levi, J. and Kates, J., “HIV: Challenging the Health Care Delivery System,” American Journal of Public Health, Vol. 90, No. 7, 2000.
Kates, J., Sorian, R., Crowley, C., Summers, T., “Critical Policy Challenges in the Third Decade of the HIV/AIDS Epidemic,” American Journal of Public Health, Vol. 92, No.7, July 2002.
Department of Health and Human Services/Kaiser Family Foundation, Guidelines for the Use of Antiretroviral Agents in HIV-infected Adults and Adolescents, February 2002, http://www.hivatis.org.
Fleming, P., et al., HIV Prevalence in the United States, 2000, 9th Conference on Retroviruses and Opportunistic Infections, Abstract #11, Oral Abstract Session 5, February 2002.
It is estimated that between 19% and 33% of those infected with HIV in the United States do not know their status. See Fleming, P. et al., note #7.
Scitovsky, A. and Rice, D., “Estimates of the Direct and Indirect Costs of Acquired Immunodeficiency Syndrome in the United States, 1985, 1986, 1991,” Public Health Reports, Vol. 102, No. 1, 1987.
Sisk, J., “The Costs of AIDS: A Review of The Estimates,” Health Affairs, Summer 1987.
Green, J. and Arno, P., “The ‘Medicaidization’ of AIDS: Trends in the Financing of HIV-Related Medical Care,” Journal of the American Medical Association, Vol. 264, No. 10, 1990.
Arno, P. and Feiden, K., Against the Odds: The Story of AIDS Drug Development, Politics, and Profits, Harper Collins, New York, 1992.
Centers for Disease Control and Prevention, HIV/AIDS Surveillance Report, Vol. 13, No. 2, 2002.
Centers for Disease Control and Prevention, “Update: AIDS—United States, 2000,” MMWR, Vol. 51, No. 27, July 2002.
This is based on average wholesale price (AWP). The price Medicaid pays for prescription drugs includes a rebate off the average manufacturers price (AMP), which itself is less than the AWP. The rebate received is defined as the greater of 15.1% of AMP or AMP minus the Best Price (BP) for brand name drugs. The rebate for generic drugs is 11% of AMP.
Bartlett, J., Medical Management of HIV Infection, 2001-2002 Edition, 2001.
Kahn, J., Haile, B., Kates, J., Chang, S., “Health and Federal Budgetary Effects of Increasing Access to Antiretroviral Medications for HIV by Expanding Medicaid,” American Journal of Public Health, Vol. 91, No. 9, September 2001.
This represents an average estimate across all payers and all HIV disease stages, based on several studies. Personal communication, James G. Kahn, January 2003.
Bozzette, S., et al., “The Care of HIV Infected Adults in the United States,” New England Journal of Medicine, Vol. 339. No. 26, December 1998.
Bozzette, S., et al., “Expenditures for the Care of HIV-Infected Patients in the Era of Highly Active Antiretroviral Therapy,” New England Journal of Medicine, Vo. 334, No. 11, March 2001.
University of Alabama (UAB), Press Release: UAB Announces Results of First HIV Patient Care Cost Analysis, July 2002. In the UAB study, the average annual cost of patient care ranged from $14,000 for those at early stage HIV infection to $34,000 for those with advanced-stage disease.
Karon, J. et al., “HIV in the United States at the Turn of the Century: An Epidemic in Transition,” American Journal of Public Health, Vol. 91, No. 7, July 2001.
Kaiser Family Foundation, Federal HIV/AIDS Spending: A Budget Chartbook, Fiscal Year 2002, September 2003.