Some states still face ADAP shortages

Despite additional federal money allocated to the nation's state-run AIDS Drug Assistance Programs, some states are still facing budget shortfalls that are forcing them to implement waiting lists or curtail the drugs they provide to low-income HIV-positive people. To date, 16 states have had to restrict access to their ADAPs, according to the annual National ADAP Monitoring Report, which was released Thursday. States that have not curtailed ADAP access, such as California, are considering establishing waiting lists or reducing the number of drugs the programs provide to eliminate budget deficits. California health officials say the state's ADAP will cost about $24 million more than was budgeted in the fiscal year beginning July 1 and that cuts of some sort may be needed to avoid overspending. Other specific challenges to the ADAPs that are boosting costs include the introduction of new, expensive anti-HIV medications, such as Trimeris and Roche's fusion inhibitor, Fuzeon, which has a price tag of about $20,000 a year; the fact that people with HIV are living longer and requiring anti-HIV drugs for longer periods of time; and growing numbers of HIV-positive people throughout the country. Bill Arnold, director of the ADAP Working Group, said ADAPs have been underfunded by the federal government for the past three years and that financial problems likely will escalate as more people need the anti-HIV medications provided through the programs. "People are piling up on waiting lists while Medicaid is dumping people who used to get coverage and private insurers, in their quiet way, are getting rid of high-cost patients," he said.