Ohio Makes Cuts to ADAP, Looks for Alternatives to Curbing Services
Budget shortfalls have forced the Ohio Department of Health to cut $1.4 million from its AIDS Drugs Assistance Program, the latest example of cuts and reductions in services being made to ADAPs across the nation, the Cleveland Plain Dealer reports. Ohio instituted its ADAP in 1996 to help underinsured and uninsured people with HIV get access to antiretroviral medications. To be eligible for the plan, Ohio residents must be HIV-positive and have incomes of less than 300% of the federal poverty level for an individual. Ohio's ADAP expenditures have more than doubled -- from $6.5 million to $14.6 millon -- over the last five years. Observers attribute the rise in costs to an increase in the number of Ohioans living with HIV/AIDS -- from around 7,000 in 1995 to 12,000 today -- and the popularity of triple-drug antiretroviral therapy, which usually includes at least one "pricey" protease inhibitor.
While other state ADAP programs have instituted waiting lists, restricted the drugs they offer enrolled patients or imposed further enrollment restrictions, Ohio is trying to avoid any service disruption by obtaining discounted medicines through a federal pool that negotiates drug rates with pharmaceutical firms. The health department is also trying to enroll into Medicaid ADAP clients who are eligible. To be eligible for Medicaid, which is paid for with a combination of state and federal funds, people with HIV must have incomes at or below the federal poverty level of $8,860 for a single person, have been diagnosed with AIDS and be unable to work. Antiretroviral treatment has been helping keep people off of Medicaid and driving up the costs of ADAPs as people with HIV/AIDS live longer. Ohio Medicaid payments for AIDS treatment declined from $42 million in fiscal year 2000 to $34.9 million in FY 2001, and the number of people with AIDS seeking treatment declined from 2,100 in 2000 to 1,861 in 2001 (McEnery, Cleveland Plain Dealer, 8/19).