For the longest time, the Massachusetts Department of Corrections dispensed HIV-positive prisoners' medication through the "Keep on Person" (KOP) program, where prisoners were given a bimonthly or monthly supply of the drugs to keep in their cell. In 2009, as a cost-saving measure, the DOC switched to dispensing HIV meds at a dispensary window.
Why? Because HIV drugs are expensive, making up more than 40 percent of the DOC's pharmacy budget. The KOP program would result in wasted medication, as prisoners would be transferred, skip taking meds, lose meds, die, or be released. The switch not only reduced costs, but also seemed to have a positive effect on the HIV-positive prisoner population as a whole; 95 percent of these prisoners now having an undetectable viral load, compared to 83 percent before the switch.
Despite that bit of positive news, five inmates sought an injunction to return the meds to the KOP program, arguing cruel and unusual punishment and deliberate indifference. As may have already guessed, their claims failed.