Oregon: Patients Face Loss of Subsidy for AIDS Drugs

In May, Oregon froze enrollment in its AIDS Drug Assistance Program (ADAP), putting access to medications in doubt for 20 to 25 patients who apply each month. ADAP provides medication to low-income patients who are ineligible for health insurance or cannot afford medications, which cost between $10,000 and $15,000 a year. Funded primarily by the federal government, ADAP is also subsidized by most state budgets. But budget crunches nationwide are forcing limitations in these state-administered programs.

Some 80,000 patients are getting drugs through ADAP, but there are now more than 1,200 patients on waiting lists nationwide. And that number keeps growing. Eight states now have waiting lists, and several expect to restrict enrollment by March 31, 2003, at the end of the ADAP fiscal year, said Jennifer Kates, senior program officer for HIV/AIDS policy at the Kaiser Family Foundation, which monitors ADAP.

The convergence of several trends is at the root of ADAP's funding problems. First is the economy. "Everyone is doing a balancing act with funding, and this is not good when you're dealing with people whose lives are on the line," Kates said.

Second is the fact that continuing advancements in AIDS treatment have made drugs more expensive without federal appropriations keeping pace. Mel Kohn, M.D., state epidemiologist with the Oregon Public Health Service, said ADAP enrollment in his state has jumped 68 percent in the past two years, and increasing drug costs have forced officials to freeze enrollments as the budget fell into the red.

Nationwide, the AIDS death rate is now 10,000 to 15,000 a year, down from the past rate of 40,000 a year. Increases in the number of HIV patients also are contributing to the crisis. About 40,000 new US cases occur each year.

Murray Penner, director of care and treatment programs for the National Alliance of State and Territorial AIDS Directors in Washington, D.C., sees problems from coast to coast. "We have a general budgetary crisis," he said. In the last nine months, programs have spent 75 percent more than in the previous year.

States are looking to the federal government for a big chunk of cash to bail them out. ADAP officials estimate they need $162 million more than Congress provided last year. Congress so far has indicated that it will offer $739 million, only $100 million more than last year's fund.

Back to other CDC news for August 28, 2002

Previous Updates