AIDS Drug Assistance Program
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The AIDS Drug Assistance Program (ADAP) was created primarily to help those with AIDS to be able to get the medications that they need. On occasion, Program funds may be used to purchase health insurance for a patient suffering from AIDS. ADAP is one of the programs that falls under the CARE Act. The CARE Act primarily functions to insure funds for primary care and support services for those that have the HIV virus and lack either health insurance or financial resources for their care. The CARE Act was passed in 1990 and reauthorized in 1996 and again in 2000 for five more years. Over 1.91 billion dollars were appropriated through the CARE Act in 2002.
If this isn't how you want to start your research paper on AIDS Drug Assistance Programs, you may want to explore these topics on AIDS instead:
- AIDS and Government Funding
- AIDS and Drug Funding
- AIDS Assistance for Disadvantaged Populations
- AIDS Funding and Ronald Reagan
AIDS and Drug Development
The first drug developed to treat the disease was zidovudine, commonly known as AZT. This drug “inhibits reverse transcriptase enzyme and stops HIV replication”. Although the drug showed initial promise, researchers soon discovered that HIV becomes resistant to the drug. The development of antiretroviral therapy (HAART) is now believed to be the most effective treatment currently available for the treatment of individuals with HIV and AIDS.
Many scientists are promoting the use of HAART, including reverse transcriptase inhibitors, protease inhibitors, and nucleoside analogues for the treatment of HIV. Individuals treated with HAART have shown remarkable improvements in their health status. However, the negative side effects associated with the treatments is drawing concern from the scientific community, especially where long-term use is considered. The most serious side effects have to do with premature atherosclerosis, which can cause difficulties with non-adherence to treatment.
Although antiretroviral treatments have reduced the mortality rate for AIDS, medical researchers warn that the guidelines for usage need to be updated on a periodic basis in order to take advantage of new drugs and treatment strategies. According to the AIDS Society-USA Panel, antiretroviral therapy should not be delayed until the CD4 cell count is 200 per mm3 as previously thought. According to some studies, delaying treatment provides a less favorable response than when treatment is started earlier. Researchers believe that when treatment is delayed, it becomes more difficult to reduce the viral load and to achieve a slower increase in CD4 cells. These studies conclude that the risks associated with antiretroviral treatments may be greater than the benefits for some patients.
Patients treated by way of antiretroviral therapy must be monitored closely given that every 10 percent deviation from total compliance results in a doubling of the viral load. In patients where the treatment is successful, the CD4 cell count increases by more than 50 cells per mm3 within four to eight weeks after the treatment begins. If the CD4 count exceeds 200 per mm3 for twelve to twenty-four weeks, some prophylactic medications can be discontinued due to the decrease in the risk of some opportunistic infections.
The Orphan Drug Act of 1983 provided a new treatment for AIDS in a roundabout way. The purpose of the Act was to provide private industry with incentives for producing unprofitable drugs to treat rare diseases. In 1989, Amgen produced Epogen to treat anemia in patients suffering from kidney failure. Given the limited number of patients suffering from this condition, the drug was not expected to be profitable for the company. However, once marketed, the drug proved useful for patients suffering from other conditions, including those diagnosed with AIDS. When used on AIDS patients, Amgen effectively restores red blood cells.
ADAP exists to help those who are in need of medications for the treatment of AIDS virus. In 2000, approximately 128,078 people received their medications with the help of ADAP. None of these nearly 130,000 people had adequate health insurance if they had any insurance at all, nor did they have the financial resources that were needed to cover the costs of the medications. Many of these people enrolled in ADAP on a temporary basis while they sought relief through other means such as insurance programs like Medicaid. An average of 73,000 people were helped each and every month through ADAP in the year 2000.
Drug Therapies Available for AIDS Patients
Until recently, doctors had a choice of 14 different drug therapies for the treatment of the disease. A common treatment regime is for patients to take at least three different drugs from two different classes. The treatments can prolong the life of the individual by strengthening the immune response and delaying the development of full-blown AIDS. Additionally, some drugs are more useful in specific patients. For example, zidovudine and nevirapine can be used to prevent the transmission of the disease from the mother to the child during pregnancy. These same drugs can be used for patients exposed to the disease in order to prevent the disease from developing, such as when health care workers are accidentally pricked by a needle used on an HIV positive patient.
In early 2003, the Swiss drug firm Roche co-developed a new drug called Fuzeon for the treatment of HIV. In Europe, the drug is expected to cost US$20,000 dollars a year, making it cost-prohibitive for many individuals suffering from the disease. The high price tag of the drug is attributed to its protein and other biological molecules that must undergo elaborate purification and are extremely difficult and costly to manufacture.
Several other drugs have been introduced in very recent history that may prove beneficial in treating HIV and AIDS. As stated by one medical expert, “I am very encouraged this year that we seem to be keeping up with the virus in terms of our ability to treat resistant virus with new drugs". In 2003, the number of drugs approved for treatment of AIDS and HIV in the United States rose to 16. A majority of these drugs are aimed at treating protease and reverse transcriptate. The new drugs currently in the development or testing phase will be capable of treating eight different points in the progression of the disease. A nonprofit company that provides HIV-related or Aids related prescription drugs to those who can't afford it is The AIDS Drug Assistance Programs.
One of the newest drugs awaiting the approval of the Food and Drug Administration is T-20, which is being developed by Roche and Trimeris pharmaceutical companies. T-20 is a fusion inhibitor that blocks HIV from sticking to blood cells. A next generation of the drug, T-1249 is designed for use when HIV develops a resistance to T-20.
Another drug that is still is the development and testing phase is TNX-355, produced by Tanox, Inc. This new drug works by blocking the spot on the blood cell where HIV attaches. Research with human subjects has shown that a single injection every one to three weeks can significantly reduce virus levels.
Another drug that showed promise has proven to be ineffective. In February 2003, VaxGen announced that its new AIDS vaccine, AIDSVAX, does not work. The company announced that of the 3,300 people who received the medication, 5.7 became infected with HIV within three years. This rate is almost the same as for individuals who did not receive the vaccine. The tests of the company showed that for some people, the AIDSVAX vaccine showed promising results. For example, the drug appeared to work better for some African Americans and Asian Americans than for individuals of other races. Of the African Americans, Asians, and people of other minority ethnicities that received the vaccine, 67 percent were protected from developing the disease. In the African American group alone, the vaccine successfully prevented 78 percent of the 203 individuals from becoming infected. Researchers are still trying to determine why the vaccine had a better success rate with some ethnic groups over others.
Even though some treatments for HIV and AIDS have proven to be successful, they may not show the same positive results for all patients. According to medical experts, treatment failures in patients with HIV and AIDS are to be expected. In most cases, the physician will change the patient to a new regime, although success with the new treatment may fail as well. Additionally, the combination of some treatments may increase the risk of multiclass drug resistance and reduce the success rate of future treatment options.
A problem with any treatment method is in getting patients to take the drugs as prescribed. Most treatment strategies require patients to strictly adhere to the treatment plan in order to be successful. This is difficult given that some of the drugs used to treat HIV and AIDS have chronic side effects. These side effects include a change is the distribution of body fat, lactic acidosis, rashes, nausea, vomiting, raised cholesterol as well as other metabolic side effects.
Eligibility for ADAP remains in the hands of each of the individual states and the programs of the state, such as AIDServe, Indiana. ADAP is different from state to state as it is decided by each state which medications will be used and how those medications are to be distributed. Many of the states use a pharmacy reimbursement model to provide the medications. Patients have to show enrollment cards at the pharmacies that are participants to ADAP. The patient then receives his or her medications and the pharmacy, in turn, sends an invoice to ADAP for reimbursement.