04/10/08

UNITED STATES:  The State of ADAP

On Tuesday in Washington, the Kaiser Family Foundation and the National Alliance of State and Territorial AIDS Directors (NASTAD) released their annual report on the US AIDS Drug Assistance Program. The $1.43 billion program was declared to be in relatively good shape, though experts noted some areas of concern.

Thanks to several factors, changes in the distribution of Ryan White CARE Act money, a real increase in supplemental funding and the one-time impact of moving some patients to Medicare Part D programs, state ADAPs were able to offer more treatment options to more patients in 2007, said NASTAD's Julie Scofield.

Indeed, for one month, no state had an ADAP waiting list - though this was short-lived, and six Montanans are now awaiting assistance. This is in marked contrast to one year ago, when South Carolina alone had nearly 600 people in need of medications until the Legislature boosted its ADAP contribution and reallocated some Ryan White dollars.

All the states have met the reauthorized Ryan White Act's requirement that drug formularies include at least one drug in the six classes of antiretrovirals used to treat HIV, and all have added two more drug classes approved last year. Most states now offer all Food and Drug Administration-approved HIV/AIDS drugs, according to the report.

Among concerns voiced by experts:
*Demand for ADAP services will likely increase as more people respond to CDC's call for routine testing and learn they are HIV-positive.
*As more Americans lose their jobs, and thus their health insurance, they can be expected to seek help through government programs.
*At the same time, the economic downturn means the federal and state governments will be even more strapped for cash.
*There is a shortage of physicians adequately trained to administer complex HIV drug regimens.

Source: Bay Area Reporter:: Bob Roehr; Courtesy of the CDC National Center for HIV, STD, and TB Prevention