September 14, 2012
As of September 13, 2012, there are 88 individuals on ADAP waiting lists in six states. With the recent receipt of the $75 million in ADAP Emergency Relief Funding (ERF), Georgia, North Carolina and Virginia no longer have individuals on their waiting lists. However, Louisiana added 24 individuals and South Dakota added one individual to the wait lists. Florida's number of individuals on their waiting list remained steady. To see a list of states with access restrictions please visit NASTAD's website.
Moving forward, due to the significant decrease in the number of individuals on waiting lists, the ADAP Watch will be released monthly on the second Friday of each month. NASTAD is committed to monitoring developments in access restrictions to ADAPs and will increase the frequency of reporting on waiting lists if the situation warrants.
ADAP enrollment is not static and ADAPs continue to experience increased strain on their programs due to new enrollment of individuals based on increased efforts to identify new individuals living with HIV or re-engagement of individuals lost to care as part the National HIV/AIDS Strategy. Even with the recent receipt of ERFs, some states were unable to close their waiting lists entirely, and two states may implement new cost containment measures or waiting lists by the end of this FY2012.
House and Senate leaders have agreed to a six month Continuing Resolution (CR) that will fund the government through March 2013 at the Budget Control Act level, which will result in approximately flat-funding at FY2012 levels. The House passed the CR yesterday and the Senate is expected to vote on this measure next week.
In an effort to streamline and assist clients in need of medications, The Common Patient Assistance Program Application (CPAPA) was launched on September 12 and is now available on the NASTAD website or at http://hab.hrsa.gov/patientassistance/index.html. This single common application allows uninsured individuals living with HIV and/or their providers/caregivers to use one application to apply for multiple patient assistance programs (PAPs) that together provide an entire course of antiretroviral therapy. To see additional 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|
(88 individuals in 6 states*, as of September 13, 2012)
|State||Number of Individuals on ADAP Waiting List||Percent of the Total ADAP Waiting List||Increase/Decrease From Previous Reporting Period||Date Waiting List Began|
|North Carolina||0||0%||-30||January 2010|
|South Dakota||10||11%||1||August 2012|
* As a result of FY2012 ADAP emergency funding, Alabama, Florida, Georgia, Idaho, Louisiana, Montana, Nebraska, North Carolina, and Virginia were able to reduce the overall number of individuals on their waiting lists.
Six ADAPs have previously lowered their financial eligibility as part of their cost-containment plans since September 2009. Illinois, North Dakota, Ohio and South Carolina lowered their eligibility level to 300% FPL. Utah lowered its eligibility level to 250% FPL. Arkansas lowered its eligibility level to 200% FPL. Previously, income eligibility for the states noted above was 400% FPL or higher. As a result of these measures, a total of 445 individuals in three states (Arkansas - 99, Ohio - 257, and Utah 89) were disenrolled. Illinois, North Dakota, and South Carolina grandfathered clients that were previously eligible based on their income level into their programs. No other ADAPs currently anticipate further changes to their financial eligibility.
Alabama: reduced formulary
Alaska: reduced formulary
Arizona: reduced formulary
Arkansas: 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)
Kentucky: reduced formulary
Louisiana: discontinued reimbursement of laboratory assays
Montana: reduced formulary
Nebraska: reduced formulary
North Carolina: reduced formulary
North Dakota: capped enrollment, instituted annual expenditure cap
Puerto Rico: reduced formulary
South Dakota: annual expenditure cap ($10,500 per client per month)
Tennessee: reduced formulary
Utah: reduced formulary
Virginia: reduced formulary, restricted eligibility criteria
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
Maine: reduced formulary
Wyoming: institute waiting list