Alabama to Cut 514 People From State's ADAP Unless State Legislature Provides $3.5 Million in Additional Funding, State Official Says

An Alabama health official on Wednesday told state lawmakers that 514 HIV-positive people will be removed from the state's AIDS Drug Assistance Program in April unless the program receives an additional $3.5 million in funding, the Birmingham News reports (Chandler, Birmingham News, 1/13). ADAPs are federal- and state-funded programs that provide HIV/AIDS-related medications to low-income, uninsured and underinsured HIV-positive individuals. President Bush in June 2004 ordered the immediate release of $20 million to purchase AIDS-related drugs for states with ADAP waiting lists, which included Alabama (Kaiser Daily HIV/AIDS Report, 12/16/04). Alabama's ADAP receives $11 million in annual federal funding and $1 million from the state, according to the News. Currently, 1,189 people are enrolled in the program and 443 people are on a waiting list, which jumped from 138 people in fiscal year 2004 after the state capped ADAP enrollment, the News reports. Without additional funding, the program will have to cut 514 people to bring enrollment down to 675, a move that will push the waiting list to 1,092 people, including projected new cases (Birmingham News, 1/13). According to a Kaiser Family Foundation fact sheet released in December 2004, Alabama was the only state to have an ADAP waiting list every month between July 2002 and November 2004 (Kaiser Family Foundation fact sheet, 12/15/04). "We think the problem in HIV and AIDS is now at crisis level," Don Williamson, an officer with the state Department of Public Health, said at a budget hearing before state lawmakers. State Rep. Laura Hall (D) said she believes the state Legislature will approve Williamson's $3.5 million request, adding, "I don't think we can afford not to." Although many HIV-positive people on the ADAP waiting list receive the drugs they need through pharmaceutical company donations, the companies might not "be willing to pick up the state's slack" if the waiting list more than doubled, Williamson said (Birmingham News, 1/13).

New Hampshire ADAP Fuzeon Policy
NHPR's "NHPR News" on Thursday reported on the policy of New Hampshire's ADAP to provide the antiretroviral drug Fuzeon on a "first come, first serve" basis to two HIV/AIDS patients in the state at any given time. All other patients seeking the drug would be placed on a waiting list (Kaufman, "NHPR News," NHPR, 1/13). Fuzeon, which is designed for HIV/AIDS patients who have failed to respond to other medications, has encountered resistance from doctors and patients because of its high cost -- about $20,000 per patient annually -- and injection delivery method (Kaiser Daily HIV/AIDS Report, 12/3/04). The segment includes comments from Maureen Byrne, a spokesperson for Roche, the maker of the drug; William Kassler, state medical director and chair of the New Hampshire ADAP medical advisory board; Bryan Marsh, an infectious disease specialist at the Dartmouth-Hitchcock Medical Center; and Mark Parsons, who has been on the waiting list since October 2004 ("NHPR News," NHPR, 1/13). A transcript of the story and complete audio of the segment in RealPlayer and Windows Media is available online.

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