Fifteen State ADAPs Have Waiting Lists, Access Restrictions; Six More States Expect New Restrictions, NASTAD Says
Fifteen states as of this month have waiting lists or access restrictions on their AIDS Drug Assistance Programs, and six more states anticipate having to impose new or additional restrictions on their programs in fiscal year 2003, according to the latest "ADAP Watch List" released yesterday by the National Alliance of State and Territorial AIDS Directors. ADAPs, which are state-managed, federally funded programs, provide HIV treatment to low-income, uninsured and underinsured HIV-positive individuals (NASTAD release, 6/23). According to the 2003 National ADAP Monitoring Report, which was based on a survey by the Kaiser Family Foundation, the National Alliance for State and Territorial AIDS Directors and the AIDS Treatment Data Network, the national ADAP budget, drug expenditures and the number of clients served by ADAPs all increased between 1996 and 2002. The number of clients served by ADAPs grew 4% last year, a rate of growth smaller than in previous years. ADAP drug expenditures grew to more than $70 million in June 2002 -- a 12% increase from June 2001 -- and total ADAP drug expenditures grew 370% between 1996 and 2002. The national ADAP budget reached $878.6 million in FY 2002, rising 8% from the year before and 366% since FY 1996 (Kaiser Daily HIV/AIDS Report, 5/1). However, federal funding for ADAPs in FY 2002 and FY 2003 has been "insufficient" to cover all qualified individuals, leading some states to impose access restrictions on the programs, according to NASTAD.
Taking into account budget shortfalls, the needs of those on waiting lists, the addition of a new class of antiretroviral drugs and hepatitis C treatment, AIDS treatment policy experts have determined that an additional $283 million will be needed for FY 2004, which begins Oct. 1, 2003, to eliminate waiting lists and access restrictions. However, the House Appropriations Subcommittee on Labor, Health and Human Services and Education last week voted to increase funding for the programs in FY 2004 by only $39 million, according to NASTAD. The full House Appropriations Committee and the Senate Appropriations Subcommittee on Labor, Health and Human Services and Education are expected to address the issue this week (NASTAD release, 6/23).