BI refuses to offer increased access to AIDS drugs for low-income Americans

AHF issued the following: Despite a growing national AIDS drug crisis, pharmaceutical giant Boehringer Ingelheim Pharmaceuticals, Inc. (BI) has steadfastly refused to offer increased access to its lifesaving AIDS drugs or to respond in any way to repeated requests by AIDS Healthcare Foundation (AHF), the largest global AIDS organization, to do its part in creating a solution.

Due to a perfect storm of AIDS budget cuts, increased demand and rising drug prices, the federally-funded, state-operated AIDS Drug Assistance program (ADAP)—which currently provides lifesaving AIDS drugs for 165,000 low-income Americans—can no longer provide treatment to all of the people who need it. As of January 2011, more than 5,300 people are on ADAP waiting lists, with an additional 2,500 at risk of being dropped from the program altogether. This crisis is quickly worsening as many larger ADAP programs are being forced to stop providing treatment to new patients. For example, Florida, which has the third highest HIV population in the country, instituted a waiting list in June 2010 that now has 2,800 people on it. California (with 40,000 ADAP patients) has proposed cuts intended to force many patients off the program.

In order to address patients' urgent medical needs, in November 2010 AHF sent a letter to all companies proposing a way to increase access by streamlining their existing Patient Assistance Programs (PAP) which act as safety nets for low-income Americans to access medications. The failure of ADAPs nationwide has made Patient Assistance Programs a lifeline for people on waiting lists and those who have been disenrolled or are no longer eligible due to other cost-containment measures.

The letter—signed by hundreds of concerned individuals as well as twelve AIDS organizations from around the country including AHF, Bienestar, ADAP Advocacy Association and Housing Works—raised concerns regarding the cumbersome application process for PAPs and suggested reasonable solutions. The letter states: "We request that you make the following changes to your PAP program: Set income eligibility at 500% of the Federal Poverty Level; create a single portal and application for patients to access all PAP programs; and, provide an option for patients to obtain medicines from their local pharmacy."

"Boehringer Ingelheim's inaction and refusal to take reasonable actions in pursuit of a solution demonstrates a shocking disregard for the lives of the patients they are supposed to be serving," said Michael Weinstein, President of AIDS Healthcare Foundation. "BI was one of the last AIDS drug companies to offer price reductions to struggling ADAPs and are now one of the only companies that has yet to expand its Patient Assistance Program to meet the current need. Gilead Science, Bristol Myers-Squibb and GSK/ViiV Healthcare have responded. Abbott Laboratories, Merck and Johnson & Johnson have taken steps to increase access. How much worse does the situation have to get before BI demonstrates a sense of responsibility to ensure that the people who need their lifesaving medications are receiving them?"

Most of the other AIDS drug companies have taken steps to increase access. For example the Heinz-Welvista program (a partnership between Heinz Family Philanthropies and Welvista Pharmacy) provides the option for patients on ADAP waiting lists to obtain medicines through a single portal and has secured participation from nearly every other AIDS drug company, except Boehringer-Ingelheim.

In addition, BI has refused to respond to AHF's follow-up letter, dated December 29, 2010 in which AHF expressed its concerns over BI's slow and insufficient response to the crisis. The letter states:

"Your refusal to expand the Virology program is even more troubling considering that it already has the most restrictive eligibility requirements in the industry. The income eligibility for your program is 200% of the Federal Poverty Level (FPL), or $1,800 gross monthly income. Given the high cost of Boehringer AIDS drugs such as Aptivus, which costs $1,187 per month, even a person making 500% of FPL ($3,500 per month in take home pay) would have difficulty in paying for this treatment without assistance. For someone with an income less than that, paying $1,187 a month for Aptivus is not an option; they will skip a month when they cannot afford to pay or stop taking treatment altogether. Given the nature of HIV to rapidly progress when untreated, this will have disastrous consequences."

In August 2010, in a previous effort to address the AIDS drug crisis in Florida, AHF proposed a program that would have streamlined the drug donation process by centralizing the availability of free treatment for patients at the pharmacy level. At the time, AHF proposed utilizing available resources—free donated medications from all the major AIDS drug companies—coupled with the streamlined dispensing of the drugs via AHF's own and other pharmacies located throughout Florida. Unfortunately, the drug companies—including BI—rejected AHF's proposal.