Use of protease inhibitors and non-nucleoside reverse transcriptase inhibitors among Medicaid beneficiaries with AIDS

Objectives. This study compared the use of new antiretroviral treatments ac ross sociodemographic subgroups during the 3 years after the introduction o f these treatments and examined diffusion of the therapies over time. Methods. Merged surveillance and claims data were used to examine use of pr otease inhibitors and non-nucleoside reverse transcriptase inhibitors (PI/N NRTIs) among New Jersey Medicaid beneficiaries with AIDS. Results. In 1996, there were sharp disparities in use of PI/NNRTI therapy a mong racial minorities and injection drug users, even after control for oth er patient characteristics. These gaps had decreased by 1998. Higher PI/NNR TI treatment rates were also observed among beneficiaries enrolled in a sta tewide HIV/AIDS-specific home- and community-based Medicaid waiver program, Conclusions. Even within a population of individuals similar in regard to h ealth coverage, there were substantial sociodemographic differences in use of PI/NNRTIs during the early years after their introduction. These differe nces narrowed as new treatments became standard. Participation in a case-ma naged Medicaid waiver program seems to be associated with a more appropriat e pattern of use. These results suggest a need to address nonfinancial barr iers to care.