Six-Month Extension of AZT Program Sent to Reagan

The House Friday approved a $15-million six-month extension of the federally supported AZT program, which for the last 19 months has purchased or subsidized the prohibitively expensive AIDS drug for an estimated 6,000 patients who could not otherwise afford it.

The measure, which was approved by the Senate Thursday, now goes to President Reagan. Rep. Edward R. Madigan (R-Ill.) said that Reagan will sign the bill.

The unusual program, which was initially approved by Congress as a one-time emergency measure, was scheduled to end Friday at the close of the fiscal year. But late Thursday afternoon, the Senate unexpectedly approved the extension on a voice vote at the urging of Sen. Lowell P. Weicker Jr. (R-Conn.), who sponsored the original program. The House approved it by voice vote late Friday afternoon.

The program was authorized by Congress at $15 million, but the drug’s manufacturer--the Burroughs Wellcome Co.--has pledged to provide $5 million of the total.

The congressional action came as a surprise to some Capitol Hill observers who said in late August that there appeared to be little chance that lawmakers would renew the program. But in recent weeks, according to aides, Weicker had been searching for ways to continue the fund and had met with several “key players” in the program, including Health and Human Services Secretary Otis R. Bowen and officials at Burroughs Wellcome to enlist their support.

“This sustains hope for the 5,000 to 6,000 people who depend on the drug to live,” Weicker said. “The job now is to devise a permanent policy.”

Rep. Henry A. Waxman (D-Los Angeles), chairman of the House Energy and Commerce subcommittee on health, who sponsored the measure in the House, agreed.

“I’m pleased we were able to get this emergency funding to continue,” Waxman said. “Without Congress acting, many people around the country would have been left without the drug. This certainly would have resulted in the loss of lives--and such a result would be unconscionable.”

AZT, also known as zidovudine, is the only drug licensed thus far to treat the symptoms of AIDS. While it is not a cure, it has been shown to significantly prolong the lives of some AIDS patients, particularly those who experience recurrent episodes of pneumocystis carinii pneumonia, a respiratory infection common to those suffering from AIDS.

The drug is extremely expensive, often costing patients as much as $800 a month.

Shortly after AZT was approved for marketing in this country, Congress established a special $30-million fund as part of the 1987 supplemental appropriations bill, and the money was made available through fiscal 1988, which ended Friday.

At the time, lawmakers realized that about 6,000 AIDS patients with limited incomes and no health insurance--who had been receiving AZT free on a “compassionate plea” basis when it was an experimental drug--would then have to buy it. Further, they knew it would take some time before states, if they chose to do so, could add AZT to their list of Medicaid-covered outpatient drugs.

The $30 million was divided among the states according to their need, and states were given the discretion of setting up their own programs to disburse the money and determine who was eligible for the benefit. Further, states were urged to come up with ways to continue the program on their own, once it expired.

California, which received $6.7 million from the program, estimated this summer that it had enough money left to cover patients until the end of April, but planned to add no new patients to the rolls after Sept. 30. The state Legislature, however, recently authorized $2.5 million in AZT money to continue the program through June, which Gov. George Deukmejian signed into law Sept. 21. As a result of the added state funds, new patients can enroll through the end of June. Many other states, however, have failed to initiate similar measures.

Since the program began, most of the states have added AZT to the list of outpatient drugs covered by Medicaid. But because the drug costs so much it is still largely unaffordable for middle-income people who lack health insurance. And to qualify for public assistance, those individuals would be forced to “spend down” their savings to virtual poverty.

AIDS, or acquired immune deficiency syndrome, is caused by a virus that destroys the body’s immune system, leaving it powerless against certain cancers and otherwise rare infections. It can also invade the central nervous system, causing severe neurological disorders. It is transmitted through sexual intercourse, through the sharing of unsterilized hypodermic needles, and by woman to fetus during pregnancy.

In this country, AIDS has primarily afflicted homosexual and bisexual men, intravenous drug users and their sexual partners. A total of 74,447 Americans have contracted AIDS, of whom 41,925 had died.