HIV Drugs Grow Rarer, Costlier as States Falter: Financial Crises Hurt Care for the Poor in Illinois, Elsewhere in U.S.

Illinois is among several states wrestling with unprecedented deficits, and its AIDS Drug Assistance Program (ADAP) for low-income patients is being challenged by increasing demand and high drug costs.

The state has seen a 14 percent spike in the number of patients enrolled in ADAP over the past year, in part because of persistently high unemployment. While Illinois has so far been able to avoid instituting a waiting list for the program, it has limited the number of available medicines, capped clients' drug expenses, and tightened enrollment. Nationwide, some 6,000 patients in at least 10 states were on waiting lists for HIV/AIDS medicines as of Feb. 3, according to the National Alliance of State & Territorial AIDS Directors.

AIDS advocates say ADAPs need approximately an additional $126 million from the federal government. The programs receive federal funds, which are then matched and administered by state governments at varying levels and structures.

A US Department of Health and Human Services spokesperson noted the federal ADAP allocation in fiscal year 2010 was $835 million, a figure that has risen during the last three years. The "[FY] 2011 amended budget totals $50 million over the [FY] 2010 enacted level for ADAP," the spokesperson said.

Illinois officials say its ADAP is one of just six nationwide that enrolls patients who have an income of up to 500 percent of the poverty level, or $54,150 for an individual. And they defend the state's $2,000 monthly cap on patients' access, citing the average per-person cost of $1,050.

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