Medication for people with HIV who do not have adequate financial resources, private insurance coverage or Medicaid is provided by funding from the Ryan White Comprehensive AIDS Resource Emergency (CARE) Act.
Enacted in 1990, the Ryan White Comprehensive AIDS Resource Emergency (CARE) Act is the largest source of federal funding specifically directed to provide primary care and support services for people living with HIV. Under Title II of the CARE Act, grants are given to individual states and other eligible areas to improve HIV health care and services.
AIDS Drug Assistance Programs (ADAPs) are one of the programs funded by Title II. There are ADAPs in all 50 states, the District of Columbia, Puerto Rico, the Virgin Islands and Guam. In 1998, ADAPs helped nearly 108,000 eligible individuals with HIV disease to receive prescription medications at no cost.
Since 1987, when ADAPs first began, the treatment of HIV disease has expanded dramatically from a single antiretroviral drug approved by the Food and Drug Administration, AZT, to 14 today. In addition to antiretrovirals that directly combat HIV, ADAPs provide drugs used to prevent and treat the opportunistic infections that may occur in the later stages of disease.
Naturally, the amount of funding for ADAPs has increased just as dramatically over the years, from $52 million in 1996 to $285.5 million in 1998. President Clinton's 1999 budget request already proposes $100 million more than that in "targeted ADAP" funds.
While federally funded, ADAPs are managed by individual states. States have the authority to determine eligibility criteria, such as household income and medical conditions, for individuals to utilize an ADAP.
States also determine which drugs will be made available through ADAP. The list of drugs available through ADAP, known as a formulary, varies from state to state.
Most states, including California, have advisory groups to assist in determining which drugs are part of the ADAP formulary. These groups usually include medical ethicists, expert clinicians, public health professionals and representatives of consumers and AIDS service providers. Some of the members of California's ADAP Medical Advisory Committee (MAC) are Dr. Wilbert Jordan, Dr. Scott Hitt, Ruben Gamundi of AIDS Project Los Angeles and Brenda Lein of Project Inform in San Francisco.
Based on the recommendations of the MAC, the number of drugs on California's ADAP formulary recently more than doubled (from 54 to 112 drugs) and now will include several new classes of drugs deemed invaluable for the well-being of HIV-infected persons. (See chart below.)
Enrolling in ADAP
To be eligible for enrollment, household income must be below $32,200 per year for a single person; below $43,400 for a family of two; and below $50,000 for a family of three.
Individuals or families whose income exceeds cut-off limits may still be eligible for ADAP through co-pay arrangements. People with a Medi-Cal share of cost may also apply for assistance. For information on eligibility requirements and enrollment locations California residents may call (800) 834-2698 and speak to an enrollment specialist by selecting "4" from the menu. The toll-free number is staffed from 9 a.m. to 7 p.m., weekdays; from 9 a.m. to 5 p.m. on Saturday; and from 11 a.m. to 4 p.m. on Sunday.
Once an individual's eligibility has been established and information entered into the ADAP computer database, prescriptions may be filled at no charge at Sav-On, Walgreen's, Rite-Aid and most large chain pharmacies. The time between data entry and availability of prescriptions is estimated at two to 24 hours.
What's in the California ADAP formulary?
saquinavir (Fortovase, Invirase
zalcitavine (ddC, HIVid
zidovudine (AZT, Retrovir)
pentamidine (Nebupent, Pentam)
TMP/SMZ (Bactrim, Septra)
trimetrexate gluconate (NeuTrexin)ANTIDEPRESSANT-SSRIs
fluoxetine hydrochloride (Prozac)
nefazodone hydrochloride (Serzone)
*paroxitine hydrochloride (Paxil)
*venlafaxine hydrochloride (Effexor)
*bupropion hydrochloride (Wellbutrin)ANTI-FUNGAL
flucytosine (5FC, Ancobon)
clotrimazole (Lotrimin, Mycelex)
*hepatitis B virus vaccine
liposomal daunorubicin (DaunoXome)
alpha-interferon (Intron-A, Roferon-A)
bleomycin sulfate (Blenoxane)
vinblastine sulfate (Velban)
Leucovorin vincristine (Oncovin)
*paclitaxel (Taxol - for KS only)ANTI-WASTING
megestrol acetate (Megace)
*oxandrolone (Oxandrin - for women
and persons with liver disease)
*amitriptyline hydrochloride (generic)
*nortriptyline hydrochloride (generic)
*trazadone hydrochloride (generic)
*despiramine hydrochloride (generic)ANTI-DIARRHEALS
*diphenoxylate hydrochloride (Lomotil)
*opium, tincture of
loperimide hydrochloride (Immodium)* new
*codeine phosphate (oral generic)
*codeine phosphate/ acetaminophen (oral generic)
*codeine phosphate/aspirin (oral generic)
*codeine sulfate (oral generic)
*hydrocodone bitartrate/acetaminophen (generic)
*hydrocodone hydrochloride (oral generic)
*fenoprofen calcium (oral generic)
*fentanyl (patch, hospice only)
*ibuprofen - prescription strength (generic)
*ibuprofen/hydrocodone bitartrate (generic)
*indomethacin (oral generic)
*ketoprofen (oral generic)
*levorphenol tartrate (oral generic)
*methadone hydrochloride (oral generic)
*morphine sulfate (oral generic)
*naproxen (oral generic)
*oxycodone hydrochloride (oral generic)
*oxycodone hydrochloride/aspirin (oral generic)
*sulindac (oral generic)ANTIBIOTICS
(All generic or oral generic)
dexamethasone (Decadron, Hexadrol)
epoetin alpha (Procrit)
Where can you enroll in ADAP in the Los Angeles area?
|People who receive medical care at any of these establishments can be enrolled by personnel on site:
|AIDS Healthcare Foundation
|AIDS Healthcare Foundation
|Long Beach Comprehensive Health Center
|AIDS Healthcare Foundation, Hollywood
|San Fernando Valley
|Children's Hospital Los Angeles
|AIDS Healthcare Foundation,
| Drew University Early Intervention Program
|Northeast Valley Health Corp.
|East Valley Community Health Center
|Harbor UCLA Medical Center
|Olive View Medical Center/Sylmar
|LAC/USC 5P21 Clinic
|Martin Luther King, Jr. Hospital
|High Desert Hospital, Lancaster
|Sheriff's Central Jail Center
The sites below will enroll eligible L.A. County residents regardless of where they receive medical care:
St. Mary Medical Center/C.A.R.E. Clinic/Long Beach --- (562) 491-9999
Tarzana Treatment Center/Lancaster --- (805) 723-4829
Jeffrey Goodman Special Care Clinic/Hollywood --- (323) 993-7500
Catalyst Foundation/Lancaster --- (805) 948-8559
H. Claude Hudson Comprehensive Health Center/L.A. --- (213) 744-6120