August 29, 2003
Restrictions Felt Nationwide
The National Alliance of State and Territorial AIDS Directors today released its September 2003 "ADAP Watch," a listing of ADAPs that have implemented or anticipate implementing restrictions. Fifteen states currently have waiting lists or access restrictions on their ADAPs, and four more states anticipate having to impose new or additional restrictions on their programs in fiscal year 2003 (NASTAD release, 8/29). ADAP representatives from California, Florida, Maryland, Massachusetts, New Jersey, New York, North Carolina and Texas -- states that collectively account for 75% annual ADAP drug expenditures -- since March have been negotiating with representatives from Bristol-Myers Squibb, Roche, GlaxoSmithKline, Merck, Pfizer, Abbott Laboratories, Boehringer Ingelheim and Gilead Sciences to discuss ways of alleviating the budget shortfalls that state ADAPs are currently facing. Earlier this month, state and territorial health officials announced that they had negotiated about $65 million in annual price concessions from the companies for antiretroviral drugs supplied through their ADAPs (Kaiser Daily HIV/AIDS Report, 8/6). AIDS treatment policy experts have said that an additional $283 million is needed for ADAPs in FY 2004 to help the programs alleviate their restrictions. The Senate appropriations bill that funds the ADAPs includes a $24.7 million increase, "which will greatly fall short of meeting the demand of those in need of life-sustaining drugs," according to NASTAD. The group encourages the Senate to increase ADAP funding, according to the release (NASTAD release, 8/29).
New Prevention Initiative May Threaten Funding
Health departments around the country also are concerned about funding changes that could come with the new federal HIV/AIDS prevention initiative announced by the CDC in April. The new initiative urges more emphasis on identifying and counseling people who are already HIV-positive. "There are huge question marks about how this will be funded," Khan said, adding that if the federal government does not provide additional funding for its new prevention initiative, money may have to be pulled from other programs, which would be "self-defeating," according to the Charleston Gazette. NASTAD last month released a statement calling several parts of the new initiative "highly troublesome to health departments." Khan said that although the state's 13 community-based AIDS organizations are probably safe from direct budget cuts as a result of the new prevention initiative, cuts to other budget items for the HIV/AIDS/STD program are possible. The funding requests for next year are due in October, and state officials should know by the end of November or early December how much money they will receive from CDC, the Gazette reports (Charleston Gazette, 8/28).
Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily HIV/AIDS Report, search the archives, or sign up for email delivery at www.kaisernetwork.org/dailyreports/hiv. The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service of the Kaiser Family Foundation, by The Advisory Board Company. © 2003 by The Advisory Board Company and Kaiser Family Foundation. All rights reserved.