May 11, 2010
Washington, D.C. -- With 1,056 people on waiting lists and many other access restrictions in place for individuals to receive consistent access to their HIV-related medications through AIDS Drug Assistance Programs (ADAPs), the ADAP Crisis Task Force (ACTF) announced that it has reached agreements with Abbott Laboratories, Merck and Co., Inc. and Tibotec Therapeutics to bring fiscal relief to the nation's state-administered ADAPs. The agreements are enhancements of long-term, existing partnerships and will help achieve savings through a mix of program adjustments including increased discounts and rebates for HIV antiretroviral treatments, price freezes on some medications as well as improved access to pharmaceutical Patient Assistance Programs (PAPs) for clients on ADAP waiting lists.
"Abbott, Merck and Tibotec's willingness to help with this crisis demonstrates that they are fully carrying their share of the burden, strengthening the case for further assistance from the federal and state governments at this critical time of unprecedented need for ADAPs," stated Jennifer Brown, Director of the Bureau of Epidemiology at the Utah Department of Health and spokesperson for the ACTF. "The ADAP Crisis Task Force and these companies have come together to find ways to bridge the gap that ADAPs are experiencing in providing life-saving medicines to our most disadvantaged and underserved populations," added Brown.
The ACTF, convened by the National Alliance of State and Territorial AIDS Directors (NASTAD), met last week with all eight companies that manufacture HIV antiretroviral treatments in an effort to provide additional rebates and discounts as well as multiple year cost protections for ADAPs which will allow increased state and federal revenues to go toward eliminating waiting lists, providing medications to new clients, and maintaining formularies.
In addition to the agreements already reached, favorable negotiations continue with Boehringer Ingelheim, Bristol-Myers Squibb, Genentech, Gilead Sciences and ViiV Healthcare. "We are hopeful that agreements similar to these newly announced ones can be completed soon with the remaining manufacturers," noted Dwayne Haught, Manager of the HIV Medication Program for the Texas Department of State Health Services and a member of the ACTF. "Abbott, Merck and Tibotec have a keen understanding of the ADAP crisis and demonstrated strong leadership by coming to the table with significant financial commitments to assist ADAPs during this crisis. They have gone far beyond the mandated discounts to develop solutions for ADAPs that will help meet the needs of nearly 200,000 HIV-positive Americans," added Haught.
NASTAD routinely monitors the status of ADAP program needs on a continual basis. While the program will yield a savings from price freezes and increased discounts and rebates in drug prices, the trend of a deteriorating situation in both state government budgets and increasing demands on ADAP program enrollment continues to accelerate, resulting in a net additional need. NASTAD and other partners estimate the program is in need of an additional $126 million in FY2010 emergency federal funding as well as critical state funding. Increased funds from the federal and state governments in addition to price freezes and increased discounts and rebates from companies are all necessary to sustain ADAPs until health reform is fully implemented in 2014.
"We believe we have reached the perfect storm where the federal and state governments and our pharmaceutical partners must step up and ensure that eligible ADAP clients have access to their medications," remarked Julie Scofield, NASTAD's Executive Director. "With company agreements in place and others at the table demonstrating their commitment, we again call upon President Obama to provide sufficient funding to ease access restrictions in ADAPs nationwide. We also urge state legislatures to maintain and increase their support of ADAPs during this critical period," she added.
The nation's current economic situation, increased HIV testing efforts and more individuals living longer have resulted in a "perfect storm" that has rapidly resulted in swelling ADAP rolls. During FY2009, clients utilizing ADAP services increased by an average of 1,271 individuals per month. This is an unprecedented increase of 80 percent from FY2008 when ADAPs experienced an average monthly growth of 706 clients. ADAPs are the safety net under other public programs, such as Medicare and Medicaid. Over seventy-five percent of ADAP clients earn less than 200 percent of the federal poverty level, which is $22,000 for an individual.
As of May 6, there were 1,056 individuals in ten states on waiting lists for ADAP. ADAP waiting lists have increased more than ten-fold in the last year (99 individuals were on ADAP waiting lists in May 2009). In addition to waiting lists, 16 states have implemented other access restrictions such as lowering financial eligibility criteria, removing drugs from their formulary and capping expenditures. To see a list of states with access restrictions please visit NASTAD's website at www.NASTAD.org.