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ADAP Waiting List Update: 35 People in 1 State as of July 23

July 28, 2014

  • There are 35 people on an AIDS Drug Assistance Program (ADAP) waiting list in one state (as of July 23, 2014).
  • Eleven ADAPs have had cost-containment measures in place since April 1, 2013 (reported as of July 15, 2014).
  • No ADAPs currently anticipate additional cost-containment measures prior to March 31, 2015.


ADAPs With Current or Anticipated Cost-Containment Measures, Including Waiting Lists, as of July 15, 2014

ADAPs With Current or Anticipated Cost-Containment Measures, Including Waiting Lists, as of November 12, 2013


ADAPs With Waiting Lists (35 Individuals in 1 State, as of July 23, 2014)

StateNumber of Individuals on ADAP Waiting ListPercent of the Total ADAP Waiting ListIncrease/Decrease From Previous Reporting PeriodDate Waiting List Began
Utah35100%+23February 2014


Waiting List Organization: Waiting list clients are prioritized by one of two models:

  • First-come, first-served model: placing individuals on the waiting list in order of receipt of a completed application and eligibility confirmation (0 ADAPs).
  • Medical criteria model: based on hierarchical medical criteria based on recommendations by the ADAP Advisory Committee (1 ADAP).

Access to Medications: Utah confirms that case management services assist clients in obtaining medications through the HarborPath ADAP waiting list program or pharmaceutical company patient assistance programs (PAPs) while clients are on the waiting list.


Latest ADAP News

The Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies passed their version of the FY2015 Labor-HHS-Education Appropriations bill, which flat funded ADAPs. Though both House and Senate leadership indicated that appropriations would take place under "regular order," the full Senate Appropriations Committee will likely not mark up their version of the bill until after the November elections. There is no House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies markup scheduled and it is now also rumored to be postponed until after the November elections. There will most likely be a short term continuing resolution funding the government until after the November elections. Depending on the outcome of the elections, there may be another continuing resolution until the start of the new Congressional session in January 2015.


ADAPs With Other Cost-Containment Strategies (Since April 1, 2013,i as of July 15, 2014)

Enrollment CapExpenditure CapFinancial EligibilityFormulary ReductionOther
Indiana
Utah
Arizona: (monthly: insurance premiums of $350); (annual: medical copayment of $3000)

Illinois: (monthly)

South Dakota: (annual)
Illinois Alabama
Alaska
Illinois
Louisiana
Maine
Georgia: cap on insurance premiums

Montana: service reductions in place

iADAPs may have other cost-containment strategies that were instituted prior to April 1, 2013.


ADAPs Considering New/Additional Cost-Containment Measures (Before March 31, 2015ii)

Enrollment CapFormulary ReductionWaiting List
LouisianaAlaskaLouisiana


In April, Alaska and Louisiana reported anticipating new cost-containment measures. As of the latest ADAP Watch survey, they both no longer anticipate these new measures due to internal system reviews. Alaska was able to keep their formulary unchanged after reviewing their overall utilization data. Louisiana was able to avoid establishing an enrollment cap and wait list due to implementation of a new pharmacy benefit management contract and changes in the state's fiscal review process that has allowed for more efficient and timely rebate processing.

iiMarch 31, 2015 is the end of ADAP FY2014. ADAP fiscal years begin April 1 and end March 31.


ADAPs That Eliminated/Modified Cost-Containment Measures (Since April 1, 2013iii, as of April 7, 2014)

Enrollment CapExpenditure CapFormulary ReductionOther
Alabama
Idaho
Wyoming
New MexicoUtahOklahoma: increase financial eligibility to 400% for individuals with insurance; 200% for uninsured.

Washington: stopped requiring use of PAPs during insurance enrollment

iiiADAPs may have other cost-containment strategies that were eliminated/modified prior to April 1, 2013.


Related Stories

2014 National ADAP Monitoring Project Annual Report (PDF)
More on ADAP Restrictions and Waiting Lists


  
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This article was provided by National Alliance of State and Territorial AIDS Directors. Visit NASTAD's website to find out more about their activities and publications.
 

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