Wyoming ADAP To Stop Accepting New Patients Due to Rising Costs, Inadequate Funds

Wyoming's AIDS Drug Assistance Program will put new applicants on a waiting list beginning Oct. 1 because of the rising cost of overall HIV/AIDS care and inadequate state funds to cover additional applicants, the AP/Billings Gazette reports (AP/Billings Gazette, 9/28). ADAPs are federal- and state-funded programs that provide HIV/AIDS-related medications to low-income, uninsured and underinsured HIV-positive individuals (Kaiser Daily HIV/AIDS Report, 9/17). The number of patients covered under the Wyoming's program has increased over time, and the program currently enrolls 87 HIV-positive people. In addition, the average number of medications used by HIV-positive people enrolled in the state ADAP has increased from three to four over the past year, according to Kurt Galbraith, the HIV/AIDS coordinator for the Wyoming Department of Health. As a result of increasing costs of HIV/AIDS medications, the cost of covering each patient in the program currently averages $1,190 per patient per month, up from $771 per patient per month in 2003, according to the AP/Gazette. Despite these changes, federal grant money for the program has remained unchanged since 2000, the AP/Gazette reports. Galbraith said that capping enrollment will allow the program to continue covering patients' medications through March 31, 2005. However, some benefits -- such as mental health counseling and transportation assistance -- have been eliminated, and patients are being referred to other programs for these services. Program officials are unsure when they will be able to begin enrolling patients again (AP/Billings Gazette, 9/25).

ADAP Funding
Although President Bush in June ordered the immediate release of $20 million to purchase AIDS-related drugs for states with ADAP waiting lists, only the 10 states that had waiting lists at the time of the order are set to benefit from the funding, according to a National Alliance of State and Territorial AIDS Directors fact sheet. The states that are eligible include Alabama, Alaska, Colorado, Idaho, Iowa, Kentucky, Montana, North Carolina, South Dakota and West Virginia. The Health Resources and Services Administration is coordinating the program with a pharmacy benefit manager to purchase the drugs and distribute them directly to individuals on the states' ADAP waiting lists as of June 21. The program can accommodate 1,750 people, who will be selected from people who are already on waiting lists in the 10 states. The number of slots each state receives will be determined by the length of its waiting list, according to the fact sheet. Since the initiative was announced, 127 people have been added to state ADAP waiting lists, and 15 states not eligible for the program have announced the implementation of cost-containment strategies or are anticipating such moves, according to the fact sheet (NASTAD fact sheet, 9/28).