Presidential Advisory Council on HIV/AIDS Conference Call: Updates on ADAP from HRSA/HAB

On Tuesday, July 29, the Presidential Advisory Council on HIV/AIDS (PACHA) held a conference call for PACHA members and the public. During the call, Dr. Deborah Parham-Hopson, Associate Administrator for HIV/AIDS, Health Resources and Services Administration at HHS, provided an update on the waiting lists for the AIDS Drug Assistance Program (ADAP), a government program providing medications for people with HIV.

The following are Dr. Parham-Hopson remarks from yesterday's call:

We in HAB, HRSA and the Department are very concerned that people living with HIV have access to care and treatment. As of today, eleven States have a total of 1,924 people on waiting lists for access to their Ryan White AIDS Drug Assistance Programs. This represents an increase of 269 people in the last week and an increase 730 people during the month of June. I have not seen such rapid increased demand for ADAP during my entire 8 year tenure as Bureau Director.

Many factors have contributed to the actual and projected ADAP shortfall within States. These factors include but are not limited to:

• more HIV testing and linkage to care efforts for HIV+ people
• access to medications and retention in care efforts has encouraged those already in the ADAP program to remain
• the economic downturn which has resulted in: increases in the number of unemployed and uninsured individuals; loss of State general revenue devoted to the ADAP activities; and cutbacks in State funded programs.

HRSA is working closely with the States to assure that those on the waiting list have access to HIV related medication through pharmaceutical manufacturers' patient assistance programs. On April 5, we awarded a total of $1.14 billion in Ryan White HIV/AIDS Program Part B funds to all States, the District of Columbia, Puerto Rico, Guam, the Virgin Islands, and Pacific Island Territories. Out of this amount, $800 million (70 percent) was directed to the ADAP Program.

Additionally, $41.7 million in Part B ADAP Supplemental Grants were awarded on April 12 to the 25 eligible States, Puerto Rico, and the Virgin Islands. HHS expects to award approximately $17.5 million in new Part B Supplemental Grant funds by August 1. States may use these additional funds to support their ADAP Programs. States may also allocate a portion of their Part B base funding for ADAP services. HRSA/HAB is in weekly contact with the ADAP directors in States that have ADAP waiting lists and those states that have other cost containment measures in place.

We provide technical assistance to enable these State programs to:

• Ensure that individuals on ADAP waiting lists have access to alternative resources for HIV/AIDS prescription drugs, such as manufacturer's pharmaceutical patient assistance programs.
• Assess current drug purchasing methods to identify additional cost-saving opportunities, e.g., switching from the 340-B Rebate Purchasing Option to the 340-B Direct Purchase Option
• Improve methods used to forecast ADAP utilization;

The Department of Health and Human Services does recognize the need to continue to improve access to critical HIV/AIDS prescription drugs.

During the call, the PACHA members also passed a resolution to address access to AIDS drugs, referencing the need for additional funding for the AIDS Drug Assistance Program (ADAP), and the need to accelerate expanded access to Medicaid coverage for people with HIV. To learn more about PACHA, visit www.pacha.gov.