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February 16, 2000

Access to Antiretroviral Therapy—Reply

Author Affiliations

Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor

JAMA. 2000;283(7):883-884. doi:10.1001/jama.283.7.882

In Reply: We agree with Dr Bassetti and colleagues that evaluation of the adequacy and availability of drug rehabilitation maintenance programs is important for ensuring access to care for active intravenous drug users with HIV disease. Currently we are investigating those issues in the cohort we have been studying.

We also agree with Dr Bartlett that it is remarkable that 79% of patients with HIV, who were uninsured, received expensive chronic therapy in early 1998, and consider this a testament to the manufacturer's access programs and the essential Ryan White CARE Act. However, we found a much larger disparity in early access to protease inhibitors and nonnucleoside reverse transcriptase inhibitors: 46% of patients who were uninsured and 53% of patients insured by Medicaid received these agents by December 1996 compared with 72% who were privately insured.

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