The AIDS drug assistance programs and coverage of HIV-related medications.
BACKGROUND
AIDS drug assistance programs (ADAPs) have been implemented in each state to facilitate access to medications for low-income, uninsured, and underinsured people with HIV disease. Policies for each ADAP differ, and these differences influence the access people with HIV have to medications.


OBJECTIVE
To compare the coverage of medications and sources of program funding for the state ADAPs.


METHODS
A self-administered mailed survey, sent to administrators of the 50 state ADAPs and the District of Columbia ADAP in December 1998.


RESULTS
Forty-nine of the 51 ADAPs (96%) responded to the survey. Title II of the Ryan White Comprehensive AIDS Resources Emergency Act provided a large majority of the funding for the ADAPs, with a number of states also using state funds and/or Title I funds for their programs. The formularies of all ADAPs were nearly identical with respect to coverage of antiretrovirals, but differed in the number and types of other medications included. Some states limited access to medications through waiting lists, enrollment caps, and other policies. Sixteen ADAPs reported that the coverage of protease inhibitors resulted in an appropriation of state government funds to their ADAP, while eight states reported an ADAP budget shortfall. In general, ADAPs in poorer and more rural states included a fewer number of medications on their formularies.


CONCLUSIONS
Access to antiretrovirals and other medications is available through state ADAPs, but may be limited in some states due to waiting lists, controls on the enrollment of new beneficiaries, and policies on the number and types of medications beneficiaries may receive.
Smith
S R
SR
Division of Pharmaceutical Policy and Evaluative Sciences, School of Pharmacy, Center for AIDS Research, the University of North Carolina at Chapel Hill, USA.
Buchanan
R J
RJ
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000191:economics*; D019380:Anti-HIV Agents / Q000191:economics* / Q000627:therapeutic use*; D005569:Formularies as Topic; D017320:HIV Protease Inhibitors / Q000191:economics / Q000627:therapeutic use; D007342:Insurance Benefits; D011632:Public Assistance / Q000191:economics / Q000331:legislation & jurisprudence / Q000639:trends*; D011795:Surveys and Questionnaires; D014481:United States
D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors