|
|
| EXCEED Project 2 |
| |
| Economic Access to Antiretroviral (ARV) Prescription Drugs and Adherence to
ARV Guidelines for African American Medicaid Enrollees with HIV-Disease in South Carolina |
| |
South Carolina ranked fifth in the U.S. with regard to rate of new cases of
HIV infection reported in 1998. Of these 76 percent were black, and one
quarter were infected through heterosexual contact. The proportion of new
HIV cases in South Carolina who are women of child-bearing age increased
from 23 percent in 1990 to 33 percent in 1997; of these more than 85 percent
are black.
The extent of under- treatment of black Medicaid HIV patients in
South Carolina is not known because Medicaid does not have a separate mechanism
for managing drug therapy for its HIV-infected clients. Even though Medicaid
HIV patients are entitled to receive the recommended drugs, in fact this
does not always happen. South Carolina is largely a rural poor state where
many black HIV patients receive their care from primary care providers who
are not familiar with the latest ARV guidelines. A disproportionately high
proportion of the 30 percent of SC's population who are black are dependent
on Medicaid for access to medical care and prescription drugs.
This project will identify the magnitude of this problem and its health and economic
consequences, and begin to develop solutions. This study will:
- use the Office of Research and Statistics (ORS) to identify black Medicaid patients
with AIDS/HIV (PWAs) who have no bills for ARV drugs, or whose prescription
drug bills are not consistent with the utilization patterns expected for
individuals adhering to ARV guidelines;
- use the ORS to group patients
with no ARV bills by primary care provider ID number, and patients with ARV
bills by pharmacy ID number and share and provide blinded data to the PI;
- estimate quality of life and budget impacts of potential improvements of
adherence to ARV guidelines for SC Medicaid patients;
- collect information and make evidence summaries of approaches from SC and other states which have
proven successful in increasing HAART drug uptake rates and/or AVR adherence
for black PWAs in rural/poverty areas; and
- provide blinded data from Step
2,along with data from Steps 3 and 4 to Medicaid staff. We will provide
analytical and consultative support to enable Medicaid officials, case managers,
medical leaders and others from the eleven regional AIDS Care Consortia to
develop culturally-sensitive plans for optimizing use and adherence to ARV
for black Medicaid PWAs in SC; and
- we will monitor Medicaid billing data
for two years and provide data based summaries/feedback to Medicaid, and
community leaders to continuously improve the system for facilitating access
and adherence to ARV guidelines for SC black Medicaid PWAs.
|
Powerpoint Presentation
|
|
