December 20, 2010
The recession has driven more patients to seek help from AIDS Drug Assistance Programs, and many states have been unable to meet the demand for ADAP services. As a result, thousands of HIV patients are left with uncertain access to treatment.
In nine states, at least 4,732 people were on ADAP waiting lists as of Dec. 16, according to the National Alliance of State & Territorial AIDS Directors. At least 19 states have taken measures such as capping enrollment, dropping patients under newly lowered income limits, creating waiting lists, and dropping coverage of certain drugs or tests. In five states, more than 300 people lost ADAP coverage this year under recently lowered income limits. By February, hundreds more could be dropped under state plans, NASTAD says.
Health officials and advocates believe most -- but not all -- patients on the waiting lists are getting antiretroviral therapy free from pharmaceutical assistance programs. An unknown number do not qualify for help due to patchy coverage and eligibility rules that vary by drug company. These stipulations -- not a physician's counsel -- ultimately can determine what antiretroviral regimen a patient winds up taking.
The House of Representatives recently approved $60 million more for ADAPs in the fiscal year beginning April 1. But the Senate has not passed the measure, and it does nothing for this fiscal year, said Ann Lefert of NASTAD. A $25 million infusion over the summer helped some states eliminate waiting lists, but it fell about $100 million short of need. Now ADAP waiting lists are bigger than ever before, she said.
Despite the growing need, Legislatures in 12 states have cut the amount they allocate to their own ADAP to supplement the federal contribution.