December 3, 2009
Facing a $375,000 shortfall in its AIDS Drug Assistance Program at the end of October, Utah lowered the maximum annual income allowable for participation and dropped 87 patients from the program. The state also closed enrollment, denying access to 36 new applicants in the past month -- even though they would have met the stricter income cutoff, said Toni Johnson, executive director of the People with AIDS Coalition of Utah.
The ADAP shortfall, Johnson said, is the result of flat funding by the federal government at a time when Utah's HIV/AIDS caseload is increasing. The US government's funding formula disburses money based on the state where diagnosis took place, Johnson said, and 28 percent of Utah's HIV/AIDS patients are from other states.
Utah does not supplement its federal ADAP funds with additional state money. While it did contribute $93,400 to help pay administration expenses, more money for ADAP anytime soon is unlikely.
Some 1,350 people access care through the HIV/AIDS clinic at the University of Utah Hospital. Now, in addition to seeing patients, Dr. Kristen Ries has to make time for the paperwork required to try to get former ADAP recipients enrolled in pharmaceutical companies' assistance programs. "We can't give the best care because we spend so much time doing the paperwork," Ries said. And as ADAPs across the country deal with similar funding crises, enrolling in these subsidy programs becomes increasingly difficult.
Another issue: Some patients must switch medications to access help from the drug makers. Changing a regimen that is not failing, Johnson said, can lead to the development of drug-resistant virus.