November 5, 2009
Since June, almost 100 people have been placed on a waiting list for Kentucky's AIDS Drug Assistance Program -- the longest line for ADAP enrollment in the nation. As people lose jobs and insurance during the recession, demand for the program's assistance has exceeded its capacity, said Sigga Jagne, Kentucky's HIV/AIDS program coordinator. In addition, federal funding for the state's ADAP dropped from about $4.8 million per year in 2005 to $4.5 million this year. The state's own annual contribution of about $250,000 ended in 2007.
"We have 20 to 30 people coming in every month, and everyone who comes in goes on the waiting list," said Jagne. "Everyone who is on the waiting list now, we don't know how long they're going to be there. Nobody is coming off the list at this point."
Through ADAP, a month's supply of the AIDS drug Reyataz costs $671, whereas it can cost $1,032 without insurance, health advocates said. Those forced to delay treatment may face adverse health outcomes. And some people who need ADAP as a bridge for insurance coverage may miss doses and risk developing drug resistance.
"People who get their medications are not always putting out fires, as it were, and rushing to the emergency room for treatment," said Bobby Edelen, an HIV-positive health activist who works with ADAP patients.
State officials are not certain how much additional money would be needed to end the waiting list. Economic forecasters are predicting a state budget shortfall of more than $1 billion over the next two years, and no lawmakers could identify sources of additional state money for ADAP.
In the meantime, the state is using additional generic drugs and steering patients toward newly enhanced COBRA insurance or charity drug programs.
As of Oct. 8, eight states had waiting ADAP lists.