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The ADAP Watch

December 9, 2011

As of December 8, 2011, there are 4,155 individuals on ADAP waiting lists in twelve (12) states. To see a list of states with access restrictions please visit NASTAD's website.

Since the release of final FY2011 Ryan White grant awards in September, including $40 million in ADAP emergency relief funding for states with waiting lists or other cost-containment measures in place, some ADAPs have been able to reduce the overall number of individuals on their waiting list. Note, however, that as states remove individuals from their waiting lists, they are adding new individuals to their program. The demand for ADAP has not dwindled and ADAP waiting lists will begin to plateau and then grow, again, in the coming months. Many ADAPs are struggling, including those without any cost-containment measures currently in place, as a result of stagnant federal and state funding and are beginning to anticipate the need for cost-containment measures, and waiting lists, in the upcoming grant year (beginning April 1, 2012).

The distribution methodology of the $35 million in additional funding that President Obama announced on World AIDS Day has not yet been determined; it is unclear how this funding will impact various cost-containment measures. Additionally the Administration has a stated goal of removing 3,000 clients from the waiting list as a direct result of receipt of the $35 million. Realizing this goal will require a shared responsibility from federal and state governments, and pharmaceutical companies.

Also please find attached a chart detailing the growth of ADAP clients served and federal ADAP funding over time. This chart clearly illustrates the growing demand for ADAP and the continued need for additional resources to keep pace with ADAP growth.

To see information on pharmaceutical company co-payment assistance and patient assistance programs, please visit the Positively Aware website or the Fair Pricing Coalition's website.

ADAPs With Waiting Lists
(4,155 Individuals in 12 States*, as of December 8, 2011)
StateNumber of Individuals on ADAP Waiting ListPercent of the Total ADAP Waiting ListIncrease/Decrease From Previous Reporting PeriodDate Waiting List Began
Alabama812%-4October 2011
Florida95423%148June 2010
Georgia1,17928%-341July 2010
Idaho110%6February 2011
Louisiana**54213%27June 2010
Montana80%-1January 2008
Nebraska100%1October 2011
North Carolina1123%6January 2010
Ohio00%0July 2010
South Carolina1373%45March 2010
Utah251%2May 2011
Virginia1,09626%-8November 2010

* As a result of FY2010 ADAP emergency funding, Hawaii, Idaho, Iowa, Kentucky, South Dakota, and Utah eliminated their waiting lists; Idaho reinstituted a waiting list in February 2011 and Utah reinstituted a waiting list in May 2011.

** Louisiana has a capped enrollment on their program. This number represents their current unmet need.


ADAPs With Other Cost-Containment Strategies: Financial Eligibility
(445 Individuals in 6 States, as of November 9, 2011)
StateLowered Financial EligibilityDisenrolled Clients
Arkansas500% to 200% FPL99 clients (September 2009)
Illinois500% to 300% FPLGrandfathered in current clients from 301-500% FPL
North Dakota400% to 300% FPLGrandfathered in current clients from 301-400% FPL
Ohio500% to 300% FPL257 clients (July 2010)
South Carolina550% to 300% FPLGrandfathered in current clients from 301-550% FPL
Utah400% to 250% FPL89 clients (September 2009)

ADAPs With Other Cost-Containment Strategies (Instituted Since April 1, 2009, as of November 9, 2011)

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Alabama: reduced formulary
Arizona: reduced formulary
Arkansas: reduced formulary
Colorado: reduced formulary
Florida: reduced formulary, transitioned 5,403 clients to Welvista from February 15 to March 31, 2011
Georgia: reduced formulary, implemented medical criteria, participating in the Alternative Method Demonstration Project
Illinois: reduced formulary, instituted monthly expenditure cap ($2,000 per client per month), disenrolled clients not accessing ADAP for 90 days
Kentucky: reduced formulary
Louisiana: discontinued reimbursement of laboratory assays
North Carolina: reduced formulary
North Dakota: capped enrollment, instituted annual expenditure cap
Ohio: reduced formulary
Puerto Rico: reduced formulary
Utah: reduced formulary
Virginia: reduced formulary, restricted eligibility criteria, transitioned 204 clients onto waiting list
Washington: instituted client cost sharing, reduced formulary, only paying insurance premiums for clients currently on antiretrovirals
Wyoming: capped enrollment, reduced formulary, instituted client cost sharing


ADAPs Considering New/Additional Cost-Containment Measures (Before March 31, 2012***)

Alaska: reduce formulary
Florida: lower financial eligibility
Hawaii: establish waiting list
Kentucky: reduce formulary
Montana: reduce formulary
Oregon: reduce formulary
Puerto Rico: reduce formulary
Tennessee: establish waiting list
Washington: establish waiting list
Wyoming: establish waiting list, lower financial eligibility, institute client cost sharing


Access to Medications (as of November 9, 2011)

Case management services are being provided to ADAP waiting list clients through ADAP (2 ADAP), Part B (9 ADAPs), contracted agencies (5 ADAPs), and other agencies, including other Parts of Ryan White (4 ADAPs).

For clients on ADAP waiting lists who are currently on or in need of medications, 11 ADAP waiting list states can confirm that ADAP waiting list clients are receiving medications through either pharmaceutical company patient assistance programs (PAPs), Welvista, or other mechanisms available within the state.

*** March 31, 2012 is the end of ADAP FY2011. ADAP fiscal years begin April 1 and ends March 31.




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