More Patients Seek Drugs Through ADAPS, Creating $50 Million Deficit

Recent increases in drug expenditures and the number of clients seeking help from AIDS Drug Assistance Programs (ADAP) have created the potential for a crisis this summer, according to ADAP Working Group Chair Bill Arnold. "We've already written to President Bush, saying, 'We've got a crisis and need emergency supplemental appropriation in this year of $50 million,'" Arnold said. Some 600 people join the ADAP rolls each month and, thanks to the effectiveness of drug therapies, attrition is not as significant as it once was. ADAP now serves about 70,000 people nationwide, and state programs reported a 22 percent increase in expenditures in June 2000 compared to June 1999, according to a report released in March. Arnold predicted some states will feel the crunch as early as next month.

Large states, including Texas, California and Florida, are expected to experience the effects of the budget shortfall first. Small states that have historically had ADAP waiting lists, like South Carolina, Alabama and West Virginia, will also likely be in trouble. In Alabama, 340 people are already awaiting enrollment, while 59 are on the list in South Carolina. This year, Florida is receiving a $5.8 million increase in ADAP funds, yet this amounts to less than a 10 percent increase at a time when enrollment is up 13 percent. Colorado's program has no waiting list and is adequately funded but that may change this year when it revises its income eligibility requirement (at 185 percent of the federal poverty level, currently one of the nation's strictest).

New York, with one of the nation's most generous ADAP formularies and one of the largest HIV-positive populations, has not had to add restrictions or put clients on a waiting list. The state's comprehensive Medicaid program provides medical and pharmaceutical coverage to HIV-infected persons whether or not they have AIDS symptoms. But if the national ADAP program does not get the $50 million emergency increase, New York may have to transfer money from other AIDS programs. State directors also hope to see Congress pass a Medicare pharmacy benefit, which would take some people out of the ADAP system.

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