title: 2007 costs and coverage of antiretrovirals under Medicare Part D for people with HIV/AIDS living in North Carolina.
abstract: BACKGROUND
  Effective January 1, 2006 Medicare Part D became a new source of prescription drug coverage for people with HIV/AIDS in the United States. The implementation of Part D has affected access to antiretrovirals for people with HIV/AIDS. In North Carolina, access can be difficult because of the state's struggling safety net programs and the growing HIV-infected populations among Blacks and in poor rural counties. This analysis examines Medicare Part D antiretroviral coverage in 2007 for beneficiaries with HIV/AIDS in North Carolina, particularly those who did not qualify as dual eligibles or for a full low-income subsidy.
  
  
  METHODS
  Data describing program coverage were obtained from the Web site www.medicare.gov and descriptive analyses were performed to assess changes in antiretroviral coverage in Part D prescription drug plans in North Carolina.
  
  
  RESULTS
  Most of the 26 antiretrovirals are covered in some way by 76 North Carolina prescription drug plans. There may be variability in coverage however associated with (a) antiretroviral classification within formularies; (b) drug premiums; (c) whether premiums can be waived; (d) annual deductibles; and (e) whether coverage is provided in the "doughnut hole."
  
  
  CONCLUSIONS
  The data may not reflect actual patterns of drug use and realized access to the drugs. The findings are limited to antiretroviral coverage in North Carolina's Part D offerings but could be generalized to other states with similar prescription drug plan costs and coverage.
  
  
  CONCLUSIONS
  These concerns continue to pose significant challenges to accessing antiretrovirals for Part D beneficiaries with HIV/AIDS in North Carolina. Variability demonstrated within prescription drug plans will continue, and beneficiaries with HIV/AIDS who do not qualify as dual eligibles or for low-income subsidies will need to evaluate these issues when selecting a prescription drug plan in future enrollment periods.
authors.affiliation: Department of Social Medicine, University of North Carolina at Chapel Hill, MacNider Hall, CB#7240, Chapel Hill, NC 27599-7240, USA. sengups@med.unc.edu
authors.forename: Sohini
authors.initials: S
authors.lastname: Sengupta
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000191:economics* / Q000453:epidemiology; D044966:Anti-Retroviral Agents / Q000191:economics* / Q000627:therapeutic use; D011307:Drug Prescriptions; D015658:HIV Infections / Q000188:drug therapy / Q000191:economics* / Q000453:epidemiology; D017048:Health Care Costs; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D007356:Insurance, Pharmaceutical Services; D054524:Medicare Part D; D009657:North Carolina / Q000453:epidemiology; D010865:Pilot Projects; D014481:United States / Q000453:epidemiology
chemical_list: D044966:Anti-Retroviral Agents