West Virginia: State's AIDS Drug Program Feeling Financial Pinch

Funding for West Virginia's AIDS Drug Assistance Program (ADAP) has climbed every year since 1998, when it was $590,000. The budget rose by 18 percent from fiscal year 2003 ($1.77 million) to fiscal 2004 ($2.09 million), according to a survey by Kaiser Family Foundation. Still, "The same problems for Medicare you read about also exist for ADAP," said Jay Adams of the state HIV Care Consortium. "Though we've never had a funding decrease, there's been less significant increases from federal funders and that's where the crisis is across the nation."

The per-patient cost of HIV/AIDS drug treatment averages $14,000 annually and increases 4-5 percent per year, Adams said. For patients with advanced AIDS, drug costs can be $23,000 per year.

Through last June, more than half of West Virginia's ADAP patients were at or below the federal poverty level of $9,310 per year for a household of one. The state's maximum eligibility level is $23,925, or 250 percent of the poverty level, Adams said. This was reduced from 300 percent of the poverty level to save money by cutting the number of eligible patients.

West Virginia had 2,080 HIV/AIDS cases through June, according to the state health department. A Kaiser Family Foundation survey shows the state as one of 11 with ADAP waiting lists. West Virginia's list has just one patient on it at present, Kaiser said. Forty-one people were able to move from the waiting list to the program thanks to a one-time $20 million initiative President Bush launched last year. But when that funding runs out in late spring or early summer, those 41 patients will be back on the waiting list, Adams said.

The number of drugs in West Virginia's ADAP formulary grew from 31 in 2003 to 33 in 2004. Louisiana, whose ADAP covers 25 drugs, is the only state offering fewer drugs than West Virginia, Kaiser reported.

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