The Fair Pricing Coalition (FPC) announced on February 1 that it has brokered agreements that will allow approximately 6,500 Floridians to continue to receive their HIV medications during a budget crisis in that state. Partners in the agreement include Welvista, a non-profit pharmacy; major manufacturers of HIV medications; and the State of Florida's AIDS Drug Assistance Program (ADAP). Florida's ADAP was expected to exhaust all available funds and shut down in early February if an emergency solution was not implemented. With these agreements, the state of Florida projects having enough funds to provide medications to its remaining 3,500 ADAP clients for the remainder of the ADAP fiscal year (through March 31, 2011). The plan will be final when the state of Florida and Welvista sign their operational agreement, expected to occur in the next several days.
Under the plan, Florida's ADAP will transition approximately 6,500 of their nearly 10,000 active clients to Welvista beginning February 14, 2011. Welvista will provide medications to these clients as a "transition" to the next ADAP fiscal year which begins April 1, 2011, when Florida's renewed allocation of federal Ryan White/ADAP funds becomes available. Clients will then again receive their medications from Florida's ADAP program.
Abbott Laboratories, Bristol-Myers Squibb (BMS), Gilead Sciences, Merck and Co., Tibotec Therapeutics and ViiV Healthcare are already participating with Welvista to expedite access to HIV medications for ADAP clients on waiting lists. Abbott, BMS, Gilead and Merck and ViiV have agreed to participate in the plan brokered by the FPC and will provide medications to Welvista for these additional clients in Florida on a one-time, emergency basis. The FPC is still negotiating with Tibotec Therapeutics and Boehringer Ingelheim about this situation.
"None of us are happy with the Florida fiasco," remarked Lynda Dee, spokesperson for the FPC. "It will result in a drain on limited funds from drug company patient assistance programs (PAPs). This inequitable use of industry PAPs could have a very significant, negative impact on the ability of other patients from other states to utilize these PAPs," Dee warned.
"We are nonetheless grateful to the companies and Welvista for their willingness to step in to provide medications for Florida patients," said Dee. "We clearly recognize this is a one-time, emergency rescue of a program that cannot be repeated or duplicated by Florida or any other state. We therefore implore the federal government and all state governments, especially Florida, to provide adequate funding to state ADAPs to meet the medication needs of its uninsured and underinsured people living with HIV," she concluded.
Nationally, state ADAPs are situated in the eye of a "perfect storm," noted the FPC release. Thousands continue to enroll in state ADAPs each year due to the economic recession and other factors which are contributing additional pressure. Positive developments such as national efforts to significantly expand HIV testing and linkages into care and new HIV treatment guidelines calling for earlier therapeutic treatments have further pushed ADAPs to a fiscal tipping point from which recovery will be difficult.
The National Alliance of State and Territorial AIDS Directors (NASTAD) reports that as of February 4, there are 6,001 individuals on ADAP waiting lists in 10 states. Additionally, 20 states have instituted, or anticipate instituting cost containment measures other than ADAP waiting lists before the end of the ADAP fiscal year ending in March 2011. Florida has the greatest number of individuals on its waiting list which will continue into the next fiscal year. Those individuals are, for the most part, already receiving medications through other pharmaceutical patient assistance resources, and are not affected by this plan. To see a list of states with access restrictions, please visit NASTAD's website at www.NASTAD.org.
The FPC remains concerned about the fiscal health of Florida's and many other state ADAPs. Moving forward, the FPC will work with local advocates to push Florida for additional state appropriations and to seek drug rebates that should have already been applied for. In addition to working on this stopgap measure, the FPC will also continue to work with all stakeholders and ADAPs on long-term solutions to the national ADAP crisis.