AIDS Drug Assistance Program
The introduction of combination therapy, or Highly Active Antiretroviral Therapy (HAART), in 1996 created a revolution in HIV treatment and has resulted in major reductions in HIV-related morbidity and mortality. Unfortunately, these treatments also come at a high price. Today, the average cost of a year's supply of anti-retroviral therapy in the U.S. is over $12,000 -- a price that is well beyond the reach of low-income individuals and others who are uninsured or under-insured. Government programs have therefore been critical in ensuring access to these medications.
One of the most important of these programs is the AIDS Drug Assistance Program (ADAP), which provides HIV and AIDS-related drugs to those who could otherwise not afford them. This program is a lifeline for thousands of low-income people living with HIV and AIDS. For those who lack adequate health insurance and do not have access to other government programs such as Medicaid, ADAP is generally the only option available to obtain these lifesaving HIV medications.
Nationally, ADAP was established in 1987 as an emergency program to provide federal support to states to help provide drugs (especially the newly discovered AZT) to individuals living with HIV/AIDS. Upon passage of the Ryan White CARE Act in 1990, the pre-existing drug access program was incorporated into Title II of that law. Like other Ryan White CARE programs, ADAPs serve as payers of last resort (i.e., this program is utilized only if no other option exists for paying for these drugs).
ADAPs exist in all U.S. states and territories. Each state administers its own ADAP and, under the CARE Act, states are given wide latitude over the specific nature of the program. States control decisions about the drugs covered by the program (the formulary) as well as the eligibility requirements and administrative procedures for the program. As a result, ADAP eligibility rules and formularies vary tremendously from state to state.
Federal ADAP funding has never been sufficient to meet the needs across the country, but in recent years, the gap between need and actual funding levels has ballooned into hundreds of millions of dollars. As a result of this funding crisis, many states have had to impose harsh restrictions on their ADAPs, including capped enrollments, waiting lists, and reduced access to certain drugs. In California, the San Francisco AIDS Foundation and other advocates have been successful in obtaining sufficient state funding to prevent such draconian restrictions, but every year we must fight to obtain the needed funding for this life-saving program.
Key Materials
- National ADAP Monitoring Project Report, 2007 [4,940K, 125-page pdf]
Report by the National ADAP Monitoring Project, an initiative of the Kaiser Family Foundation and the National Alliance of State and Territorial AIDS Directors (NASTAD), which provides comprehensive data and information about ADAPs across the country.
- National ADAP Monitoring Report, 2007, Exec. Summ. [2,856K, 19-page pdf]
Executive Summary of the 2006 National ADAP Monitoring Report
- NASTAD ADAP Watch, April 2007 [131K, 2-page pdf]
A periodic report by NASTAD that provides information about the number of individuals currently on ADAP waiting lists throughout the country as well as a listing of states with other ADAP cost-containment strategies in place.
- Over 1,500 on State ADAP Waiting Lists, Dec 2005 [39K, 2-page pdf]
NASTAD press release on December 6, 2005 regarding number of Americans currently on ADAP waiting lists.
- ADAP Formularies as of November 2006 [PDF on www.nastad.org]
Provides a list of all state ADAP formulary lists as of November 2006.
- Fact Sheet on Waiting for HIV Meds, KFF [PDF on www.kff.org]
Kaiser Family Foundation Fact Sheet, "Waiting for AIDS Medications in the United States: An Analysis of ADAP Waiting Lists," December 2004.
- President Bush's $20M ADAP Initiative - NASTAD [43K, 2-page pdf]
Fact sheet produced by NASTAD about the President's $20 million ADAP initiative that was announced in June 2004.
- ADAP in Peril [ on www.sfaf.org]
Article by Fred Dillon, San Francisco AIDS Foundation policy and communications director, "ADAP in Peril," BETA, Summer 2004.
- Journal of Care for People with HIV Disease [ on www.adapfund.org]
Provides a variety of articles and perspectives regarding ADAP and other issues related to accessing HIV care in the United States. Published January 2004.
HIV Policy Watch articles on this issue
OUTReach articles on this issue
Press releases on this issue
Links to other key organizations involved in this issue
- Access Project of the AIDS Treatment Data Network
The Access Project is an information clearinghouse that collects and distributes information about medications available for HIV and AIDS through Medicaid, AIDS Drug Assistance Programs (ADAPs), and pharmaceutical industry sponsored patient assistance and expanded access programs.
- AIDS Action Council
AIDS Action is a national organization dedicated to the development, analysis, cultivation, and encouragement of sound policies and programs in response to the HIV epidemic.
- AIDS Drug Assistance Protocol Fund
The mission of the AIDS Drug Assistance Protocol Fund is to facilitate access to HIV and HCV drugs
for medically indigent individuals that are currently on ADAP waiting lists.
- Communities Advocating Emergency AIDS Relief (CAEAR) Coalition
The Communities Advocating Emergency AIDS Relief (CAEAR) Coalition represents more than 400 grantees under Title I and Title III of the Ryan White CARE Act, including the 51 major metropolitan areas most adversely affected by the HIV/AIDS epidemic, as well as providers and consumers of CARE Act-funded services. The CAEAR Coalition also advocates for adequate funding for the AIDS Drug Assistance Program (ADAP) in Title II of the CARE Act.
- National Alliance of State and Territorial AIDS Directors (NASTAD)
Founded in 1992, NASTAD is a non-profit national association of state health department HIV/AIDS program directors who have programmatic responsibility for administering HIV/AIDS health care, prevention, education, and supportive services programs funded by state and federal governments.
- Project Inform
Project Inform is a national, nonprofit, community-based organization working to end the AIDS epidemic. The agency works to inform people living with HIV, their caregivers, and their healthcare and service providers about the treatment and monitoring of HIV disease and to advocate for appropriate policies, legislation and funding for HIV research, treatment and care.
- Treatment Access Expansion Project
Established in 1998, TAEP's mission is to improve access to early and comprehensive treatment ensuring that individuals living with HIV get the care they need.
Page last updated:
10/19/2007