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ADAP Crisis Worsens; Waiting Lists Near Historical High
"Advocates continue to work with their state legislators to shore up general revenue contributions to ADAPs and many of the major pharmaceutical companies have reached agreements with the ADAP Crisis Task Force. Now it is the federal government's turns to pitch in,"
from Jules: how much do we spend globally on HIV? but we can't adequately address our domestic HIV issues including ADAP, HCV and HCV/HIV coinfection, housing, and services for African-Amercians because this community does not succeed as well on HAART compared to whites nor Latinos- we have been struggling with this particular issues for years without adequate solutions.

Washington, DC - June 18, 2010 - There are now 1,596 people on waiting lists to receive consistent access to their HIV-related medications through AIDS Drug Assistance Programs (ADAPs). This number nearly tops the historical high of 1,629 people on waiting lists in May 2004. The National Alliance of State and Territorial AIDS Directors (NASTAD) implores the Obama Administration and Congress to take immediate action to provide relief to the nation's struggling ADAPs. The program is in need of an additional $126 million in FY2010 emergency funding in order to ensure access to lifesaving medications for those in need.
As of June 17, 1,596 individuals in ten states were on ADAP waiting lists. ADAP waiting lists have increased 40 percent in the last month (from 1,143 people on May 20, 2010). In addition to waiting lists, 12 states have implemented or anticipate implementing other access restrictions such as lowering financial eligibility criteria, removing drugs from their formulary and capping expenditures. To see a list of states with access restrictions please visit NASTAD's website at
"ADAPs are struggling to meet the demand for life-saving medications in their states," stated Julie Scofield, NASTAD's Executive Director. "The lack of additional resources to address the crisis is unacceptable and is resulting in increased waiting list numbers and other access restrictions." The current economic crisis continues to heavily impact ADAPs. In FY2008, over 200,000 individuals relied on ADAPs for their medications. This includes nearly 40,000 new clients to the program. ADAPs experienced a 14 percent increase in client utilization between June 2008 and June 2009. Individuals losing their jobs and insurance as well as increased HIV testing efforts are contributing to the number of individuals relying on safety net services such as ADAP.
"President Obama and Congress must address the growing ADAP crisis and provide relief to states to ensure that clients can receive comprehensive and consistent access to their medications," remarked Scofield. "Advocates continue to work with their state legislators to shore up general revenue contributions to ADAPs and many of the major pharmaceutical companies have reached agreements with the ADAP Crisis Task Force. Now it is the federal government's turns to pitch in," she added.
The ADAP Crisis Task Force (Task Force), convened by NASTAD, has successfully reached agreements with six of the eight major antiretroviral manufacturers. These agreements will provide additional rebates and discounts as well as multiple year cost protections for ADAPs which will allow increased state and federal revenues to go toward eliminating waiting lists, providing medications to new clients, and maintaining formularies. The Task Force continues to negotiate with the remaining companies.
ADAPs are the safety net under other public programs, such as Medicare and Medicaid. Seventy-seven percent of ADAP clients earn less than 200 percent of the federal poverty level, which is $22,000 for an individual. NASTAD estimates that the additional $126 million needed in FY2010 emergency federal funding will only allow states to continue their programs with the same composition, not expand their programs in any way. Emergency funding to curtail ADAP waiting lists has not been available since 2004 when President Bush provided additional funds to the program.
Founded in 1992, NASTAD is a nonprofit national association of state and territorial health department HIV/AIDS program directors who have programmatic responsibility for administering HIV/AIDS and viral hepatitis health care, prevention, education, and supportive services programs funded by state and federal governments. For more information, visit
Contact: Ann Lefert

ADAPs with Other Cost-containment Strategies (instituted since April 1, 2009)
Arizona: reduced formulary
Arkansas: reduced formulary, lowered financial eligibility to 200% of FPL Colorado: reduced formulary
Illinois: reduced formulary
Iowa: reduced formulary
Kentucky: reduced formulary
Louisiana: capped enrollment, discontinued reimbursement of laboratory assays Missouri: reduced formulary
North Carolina: reduced formulary
North Dakota: capped enrollment, cap on Fuzeon, lowered financial eligibility to 300% FPL
Utah: reduced formulary, lowered financial eligibility to 250% FPL
Washington: client cost sharing, reduced formulary (for uninsured clients only)
ADAPs Considering New/Additional Cost-containment Measures (before March 31, 2011*)
Arizona: waiting list
California: proposed elimination of ADAP services in city and county jails
Florida: reduced formulary, lowered financial eligibility
Illinois: reduced formulary, lowered financial eligibility, monthly expenditure cap
Ohio: reduced formulary, lowered financial eligibility, capped enrollment, client cost sharing, annual and monthly expenditure caps
Oregon: reduced formulary, client cost sharing, annual expenditure cap Wyoming: reduced formulary
*March 31, 2011 is the end of ADAP FY2010. ADAP fiscal years begin April 1 and end March 31.
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