PROTEASE INHIBITORS: MAY BE REDUCING AIDS TREATMENT COSTS

      Less than a year after the introduction of protease
 inhibitors, medical centers around the country are seeing the
 first indications that the AIDS-fighting drugs are leading to a
 decline in "the use of expensive inpatient health services by
 AIDS patients."  WALL STREET JOURNAL reports that "preliminary
 and largely anecdotal" data from medical centers that treat "a
 large number of HIV-infected people" suggests that the drugs may
 "generate long-term health savings that could offset their cost." 
 According to a federal study, AIDS patient account for
 approximately $24,000 per year in hospital costs; protease
 inhibitors cost about $16,000 a year per patient.  
      TREND FOR THE FUTURE:  Physicians and hospital officials in
 California and New York said "they are seeing the most
 significant decline in acute-care services since the epidemic
 exploded over 12 years ago."  Peter Ruane, a physician with a Los
 Angeles-based AIDS practice, said, "As a group, my patients
 aren't anywhere near as sick -- or sick as often -- as they
 were."  He added, "We may be in the midst of the most radical
 medical change in our field since the first arrival of drugs for
 (tuberculosis) in the 1950s."  Michael Weinstein, president of
 AIDS Healthcare Foundation in Los Angeles, said that the "demand
 for hospice beds is radically diminishing."  Health officials
 said that private organizations and the government may have to
 shift some of the AIDS monies spent on medical care to funding
 for drug therapy, including "outpatient services to provide the
 drugs and the close monitoring that the drugs' use requires."
      NEW SPECIALTY:  Doctors working with the protease inhibitors
 said that "figuring out precisely which combinations of the nine
 drugs available work best for each patient has required an
 increase in time and expertise."  Dr. Michael Saag, an AIDS
 researcher at the University of Alabama in Birmingham, said that
 "the best care can only come from doctors who really understand
 the nuances of the different drugs" (Waldholz, 10/10).