The AIDS Drug Assistance Program (ADAP) provides free life-saving medications to treat HIV/AIDS and other opportunistic infections. It's designed for those people living with HIV/AIDS who are low-income and underinsured or uninsured. There are about 200,000 people enrolled in ADAP, making it an essential lifeline nationwide. ADAP is funded by a combination of federal funds, state government funds, and rebates provided by pharmaceutical companies.
The issue: A Perfect Storm
In the 2000s, federal funding has remained stagnant, and states have not fared much better. With the recent economic recession, more and more people are losing their jobs and forced to go on unemployment. This loss of employer-sponsored health insurance in combination with shrinking government resources has created what is often called "a perfect storm" that could have devastating effects on thousands of uninsured Americans living with HIV/AIDS.
In an effort to address the growing number of individuals who need ADAP to continue critical treatment, many states have created ADAP waiting lists. For more information on the current waiting list numbers, the National Alliance of State and Territorial AIDS Directors (NASTAD) compiles monthly figures.
Other Cost-Containment Strategies
- Reducing Income Eligibility
Some states have opted to impose cost-containment strategies in addition to or instead of waiting lists. This often means that people who make less than 300% of the federal poverty level will be eligible for ADAP coverage. But for people making so little, whose AIDS drugs may cost $25,000 or more annually, changing income eligibility requirements provides very little real relief.
- Reducing Formularies
Another way in which ADAPs try to decrease the costs associated with the program is by reducing formularies, the lists of medications that ADAP can cover. A large percentage of ADAP budgets are dedicated to antiretroviral medications, with the remainder funding medications that treat opportunistic infections or drugs that treat the side effects of antiretrovirals. A decrease in the formulary may, effectively, seriously decrease the quality of life for people living with HIV/AIDS.
What can I do?
Although ADAPs are coordinated by states, individuals in other states can help mobilize and advocate for ADAP funding on a national scale and call on their senators and representatives to support more federal funding for ADAPs. Writing letters, calling government officials, and meeting representatives are all ways in which people can help address the ADAP crisis.
For the best resources on ADAP background and advocacy, check out these sites: