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State AIDS Drug Assistance Programs (ADAPs) provide medications for about 25% of all HIV-infected patients enrolled in care in the U.S. In some states, limited funding means not enough medication for everyone; most states then create a first-come, first-served wait list. Massachusetts researchers suggested in 2006 that a wait list based on CD4-cell count would be cheaper and more cost-effective than a first-come, first-served wait list (JW AIDS Clin Care Nov 27 2006). They have now quantitated the expected health benefits of such an approach.
The researchers created a hypothetical cohort of patients applying to ADAP (based on actual Massachusetts figures) and then used a mathematical model to compare the morbidity and mortality associated wi…