NASTAD Issues New Report on Current ADAP Waiting Lists, Cost-containment Measures, and Projected Future Needs

By Liz Highleyman

As previously reported, the National Alliance of State and Territorial AIDS Directors (NASTAD) announced last September that -- for the first time since the group began keeping track in 2002 -- no patients in any U.S. states or territories were on waiting lists for AIDS Drug Assistance Programs (ADAPs).

Since then, however, the number of ADAPs that have instituted waiting lists or other cost-containment measures has crept up, as state and federal funding fails to fully meet the growing need for treatment.

In the July 2008 issue of The ADAP Watch, NASTAD reported that there are now 35 people waiting for ADAP enrollment in 2 states, 28 in Indiana and 7 in Montana.

Montana and Utah implemented other cost-containment measures since the beginning of the ADAP fiscal year on April 1. Indiana and Arizona reported that they anticipate the need to institute further cost-control measures during the current fiscal year. Such measures typically include limitations on drug formularies; most states already restrict their formularies to antiretroviral drugs only, and provide no medications for associated conditions.

Since ADAPs are funded with a combination of state and federal money, the level of coverage varies greatly, as some states allocate more resources than others. Due to increasing demand for ADAP coverage, states have been faced with decisions about whether to prioritize drugs over other medical and support services -- such as case management, substance abuse treatment, housing, and food vouchers -- covered under Part B of the Ryan White CARE Act.

While the number of states with waiting lists and other cost-containment measures remains low in comparison to prior years, the latest report says that the future of ADAP is "uncertain," since the prospect for adequate funding increases for 2009 "remains bleak."

NASTAD estimates that ADAP will require $929 million in federal funds in fiscal year 2009, an increase of $135 million over the current year. Ryan White funding is currently being considered by Congress, but the amounts under discussion would not fully meet the projected need.

The current edition of The ADAP Watch report is available online at www.nastad.org.

7/15/08

Sources

National Alliance of State and Territorial AIDS Directors. The ADAP Watch. July 10, 2008.

Kaiser Family Foundation. Report Examines ADAP Waiting Lists, Other Cost-Containment Measures. Kaiser Daily HIV/AIDS Report. July 11, 2008.