ADAP Watch 7.19.12

The Administration has pledged new money to end the waiting lists, but they will linger for some time. Making sure that everyone who needs ART drugs can get them is an obvious first step towards ending this country’s HIV/AIDS epidemic, but when the waiting lists are gone, we’ll have to move on to the hard work of changing attitudes towards people with HIV and ensuring access to health care for all Americans, not just those living with HIV.

It was grimly entertaining, explaining to Conference delegates from Canada and Germany what ADAP is and why we have waiting lists, when it’s so obviously better public health policy and so obviously more fiscally prudent to treat everyone with HIV who wants treatment. After she got past her initial disbelief, a German delegate gently suggested that there are better ways to handle this sort of thing. We wouldn’t need ADAPs, let alone have ADAP waiting lists, if we had a rationally designed national health care system.

Here are the latest numbers from our friends at NASTAD:

ADAP Watch (dgsmith.org)
Montana ADAP Waiting List: Tuesday: 0, Wednesday: 1 (dgsmith.org)
Keeping Up with AIDS 2012: Conference continues in the convention center, in the streets and in the spotlight (metroweekly.com)

AIDS Drug Assistance Program (ADAP) Watch 7/1/12

Jul2 by D Gregory Smith

From NAPWA:

The waiting list numbers continue steady, just over 2,000, down from 9,000 in September of last year.

Coming off another National HIV Testing Day, we have to wonder how some states can encourage their citizens to get tested but not help them get lifesaving medicines if they test positive.

We also wonder what kind of cost analyses the waiting list states are doing. The cost of clearing the waiting lists completely just isn’t that great. Virginia has just under 600 PLWHA on its waiting list. If drugs cost $15,000 for one ADAP beneficiary for one year, drugs for 600 will cost $9 million – and we just don’t believe $9 million can’t be found in an $85 billion fiscal 2013 Virginia state budget. PLWHA on Virginia’s and other states’ waiting lists will cost the public sector a lot more if they don’t get drugs that can keep them from progressing to AIDS.

Here are the latest numbers from our friends at NASTAD:

‘Take The Test, Take Control’ On National HIV Testing Day (huffingtonpost.com)
Montana ADAP Waiting List: Tuesday: 0, Wednesday: 1 (dgsmith.org)
It’s National HIV Testing Day: Where You Can Get Tested for Free (laist.com)

ADAP Watch, May 31, 2012

Jun4 by D Gregory Smith

From The National Association Of People With AIDS:

It’s just over two years now since we first reported the ADAP funding crisis. We thought it would be over quickly. Sad to say, we were wrong. The number of ADAP-qualifying lower-income Americans on waiting lists for the HIV drugs that would keep them healthy peaked last year at more than nine thousand before coming down to this May 31’s 2,357.

More than 90% of those now wait-listed are in five Southern states: Alabama, Florida, Georgia, Louisiana, and North Carolina. All five have legitimate state budget shortfalls. All five, however, also have increasingly serious rural HIV epidemics, and extending immediate ADAP drug assistance to everyone who qualifies would be a useful step towards slowing the spread of the virus. The additional cost to the states would be trivial in the context of their whole state budgets – eliminating state ADAP contributions altogether would not materially improve their fiscal situations, and doubling them would not make them materially worse.

Here are the latest numbers from our friends at NASTAD:

ADAP Watch (dgsmith.org)
Montana ADAP Waiting List: Tuesday: 0, Wednesday: 1 (dgsmith.org)
Sanders plan to lower HIV drug cost (politico.com)

ADAP Watch

May21 by D Gregory Smith

From NAPWA: Recently released supplemental federal funding is slowly bringing state waiting lists down – 2,552 this week. Regional disparities are troubling, though. Ninety percent of Americans on ADAP waiting lists are in the South. The only non-Southern state with comparable numbers is Nebraska. The South is where HIV is spreading fastest, and providing HIV drugs to those who need them would help prevent new infections.

Here are the latest numbers from our friends at NASTAD:

Montana ADAP Waiting List: Tuesday: 0, Wednesday: 1 (dgsmith.org)
MT ADAP Wait List: Tuesday, 0; Wednesday 1 (bilerico.com)
Some Startling HIV Facts (dgsmith.org)

ADAP Watch March 12, 2012

Mar12 by D Gregory Smith

From our friends at NAPWA:

The President has called for The End of AIDS in America, and that means an end to ADAP waiting lists. Everyone who needs HIV antiretroviral medicines should be getting them, and we can reduce long-term health care costs by making sure they do.
This is an extraordinarily difficult political climate, though, so we don’t expect much movement on the waiting lists until after the elections. We’re grateful to the Administration for the new money that brought the counts down from 9,000-plus to just under 4,000, and we think it’s time for states like Virginia and Georgia to join the Administration and pay their fair share. Belly up to the bar, boys!
Here are the latest waiting list numbers from our friends at NASTAD. Let’s not forget that these are the visible waiting lists. Too many states have vanished PLWHA who used to qualify for ADAP assistance by setting income eligibility ceilings unreasonably low.

ADAP Watch 12/19/11 (dgsma.wordpress.com)
ADAP Watch 1/13/2012 (dgsma.wordpress.com)
Merck And The ADAP Crisis Task Force Announce New Agreement To Improve Access And Care For People With HIV (medicalnewstoday.com)
Teenagers Born With HIV Tell of Life Under Society’s Radar (lass.org.uk)

ADAP Watch 1/13/2012

Jan16 by D Gregory Smith

ADAPs With Waiting Lists (4,717 individuals in 12 states*, as of January 12, 2012)
State	Number of Individuals on ADAP Waiting List	Percent of the Total ADAP Waiting List	Increase/Decrease From Previous Reporting Period	Date Waiting List Began
Alabama	47	1%	-44	October 2011
Florida	1,301	28%	135	June 2010
Georgia	1,275	27%	-12	July 2010
Idaho	6	0.1%	-3	February 2011
Louisiana**	628	13%	27	June 2010
Montana	11	0.2%	-2	January 2008
Nebraska	17	0.4%	2	October 2011
North Carolina	126	3%	1	January 2010
Ohio	0	0%	0	July 2010
South Carolina	164	3%	0	March 2010
Utah	32	1%	0	May 2011
Virginia	1,110	24%	7	November 2010
* As a result of FY2011 ADAP emergency funding, Alabama, Florida, Georgia, Idaho, Louisiana, Montana, North Carolina, Ohio, South Carolina, Utah, and Virginia were able to reduce the overall number of individuals on their waiting lists. ** Louisiana has a capped enrollment on their program. This number represents their current unmet need.

ADAPs With Other Cost-Containment Strategies: Financial Eligibility (445 Individuals in 6 States, as of November 9, 2011)
State	Lowered Financial Eligibility	Disenrolled Clients
Arkansas	500% to 200% FPL	99 clients (September 2009)
Illinois	500% to 300% FPL	Grandfathered in current clients from 301-500% FPL
North Dakota	400% to 300% FPL	Grandfathered in current clients from 301-400% FPL
Ohio	500% to 300% FPL	257 clients (July 2010)
South Carolina	550% to 300% FPL	Grandfathered in current clients from 301-550% FPL
Utah	400% to 250% FPL	89 clients (September 2009)

ADAPs with Other Cost-containment Strategies (instituted since April 1, 2009, as of November 9, 2011)

Alabama: reduced formulary Arizona: reduced formulary Arkansas: reduced formulary Colorado: reduced formulary Florida: reduced formulary, transitioned 5,403 clients to Welvista from February 15 to March 31, 2011 Georgia: reduced formulary, implemented medical criteria, participating in the Alternative Method Demonstration Project Illinois: reduced formulary, instituted monthly expenditure cap ($2,000 per client per month), disenrolled clients not accessing ADAP for 90-days Kentucky: reduced formulary Louisiana: discontinued reimbursement of laboratory assays North Carolina: reduced formulary North Dakota: capped enrollment, instituted annual expenditure cap Ohio: reduced formulary Puerto Rico: reduced formulary Utah: reduced formulary Virginia: reduced formulary, restricted eligibility criteria, transitioned 204 clients onto waiting list Washington: instituted client cost sharing, reduced formulary, only paying insurance premiums for clients currently on antiretrovirals Wyoming: capped enrollment, reduced formulary, instituted client cost sharing

ADAPs Considering New/Additional Cost-containment Measures (before March 31, 2012***)

Alaska: reduce formulary Florida: lower financial eligibility Kentucky: reduce formulary Montana: reduce formulary Oregon: reduce formulary Puerto Rico: reduce formulary Tennessee: establish waiting list Wyoming: establish waiting list, lower financial eligibility, institute client cost sharing

Access to Medications (as of November 9, 2011)

Case management services are being provided to ADAP waiting list clients through ADAP (2 ADAP), Part B (9 ADAPs), contracted agencies (5 ADAPs), and other agencies, including other Parts of Ryan White (4 ADAPs).

For clients on ADAP waiting lists who are currently on or in need of medications, 11 ADAP waiting list states can confirm that ADAP waiting list clients are receiving medications through either pharmaceutical company patient assistance programs (PAPs), Welvista, or other mechanisms available within the state.

***March 31, 2012 is the end of ADAP FY2011. ADAP fiscal years begin April 1 and ends March 31. To receive The ADAP Watch, please e-mail Britten Pund at bpund@NASTAD.org.

HIV Prevention Urged; Activists Protest AIDS Drug Assistance Waitlists: VIDEOS (towleroad.com)
Obama Admin Releases $1.89 Billion In Grants For HIV/AIDS Funding (thinkprogress.org)
Merck And The ADAP Crisis Task Force Announce New Agreement To Improve Access And Care For People With HIV (medicalnewstoday.com)
The AIDS Drug Assistance Programs Wait List (bilerico.com)

ADAP Watch 12/19/11

Dec19 by D Gregory Smith

From NAPWA:

President Obama called for the end of AIDS on World AIDS Day. But achieving that in America requires more public sector funding than Congress has provided to date, and the political climate for more funding is brutal.

We could make a classic business Republican argument for more funds: the increases would be trivial in the context of a $3.5 trillion federal budget, and the rate of return on investment would be as high as it gets – reduced public sector health care costs in future years, and improved private sector productivity. It cost next to nothing (in context) this year, and it pays back big for years to come.

With recent additional federal money, ADAP waiting list numbers have come down some over the past month, but more than 4,000 Americans are still on wait lists. Ninety percent of them are in four Southern states, Florida, Georgia, Louisiana, and Virginia. All four are having financial difficulties in this economy, but the millions of dollars they would have to spend to eliminate their waiting lists are insignificant in multibillion dollar budgets, and spending the millions or not will not make their difficult positions materially any worse or any better.

Here are the latest numbers from our friends at NASTAD: