The Trouble With ADAP

Nearly 10,000 people in 11 states across the country are already being turned away from state-funded AIDS Drug Assistance Programs due to under-funding, but for some there are alternatives to getting help. The most viable alternative for people who have been cut off from these programs can be to simply go directly to the source: the pharmaceutical companies. Be prepared, though, Ged Kenslea of the AIDS Healthcare Foundation cautions that doing so may mean more legwork for people looking for medication. 'In a sense, ADAP provides one-stop shopping if you're taking more than one medication,' Kenslea says. When it comes to the drug company-run patient assistant programs, he warns that complications may begin on a basic level, when an HIVer might need three different medicines that come from three different companies. 'Some have efficient patient assistant programs,' he says, 'but if you can't get the other two drugs that you need, in order to take the one pill that you were able to get, it might throw out your plans.' In addition to ensuring that all medications come in at the right time, Kenslea says HIVers should plan for the different types of time consuming requirements'like sending medical requests via fax'which some companies require. The AIDS Healthcare Foundation has also been lobbying states not to make eligibility changes that would shut people out of ADAP programs. Initially, many state ADAPs were open to HIVers making less than $44,000 annually. Some states, like Florida and Ohio, have considered halving that, so anyone earning more than $22,000 per year would be shut out of the program. 'What has been even more odious than a waiting list, has been that some states with waiting lists are considering changing eligibility criteria completely,' he says. The result inevitably means lower income cutoffs for people who are employed, but still need help in affording costly HIV drugs. In the meantime, the U.S. Senate's Labor, Health and Human Services, Education and Related Agencies Appropriations Subcommittee recommended in September that federal funding to states for their ADAPs would receive a $15 million boost in 2012. While that won't have a vast effect for people waiting for ADAP, it is a small step in tackling a major hurdle. Carl Schmid, deputy executive director of The AIDS Institute, says the drugs and knowledge exist to save more lives, but he said the small increase is not enough. President Obama asked Congress for a $55 million increase for ADAP funding, and The AIDS Institute lobbied for a $106 million increase to eradicate waiting lists. According to the organization, the subcommittee's proposed increase would reduce the waiting list by only about 1,300 individuals'or just 15% of the people on the waiting lists. 'Our nation,' he says, 'is not going to reduce new HIV infections or provide adequate care and treatment to low-income people living with HIV/AIDS without new resources.'