The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #60406

Amy Wolfson, MPH, Westat, 1650 Research Blvd., Rockville, MD 20850, 301-738-8370, wolfsoar@worldnet.att.net, Paul J. Mahanna, MA, Health Division, OMB, 725 17th Street, NW, Room 7026, Washington, DC 20503, and Faye E. Malitz, MS, Office of Science and Epidemiology, HIV/AIDS Bureau, Health Resources and Services Administration, Dept of Health and Human Services, Parklawn Bldg Rm 7-90, 5600 Fishers Lane, Rockville, MD 20857.

The Ryan White AIDS Drug Assistance Program (ADAP) provides HIV-related prescription medications to under- and un-insured individuals living with HIV/AIDS. Unlike Medicaid, the largest provider of HIV care, ADAPs are payers of last resort, and rely on annual appropriations to provide prescription drugs to clients.

The cost of health care continues to increase dramatically. Prescription medications for the prevention and treatment of HIV are critical for HIV-infected individuals. These medications continue to cost between $10,000 and $12,000 per year, which presents a significant barrier for HIV/AIDS individuals who do not have access to private or public insurance or whose insurance does not sufficiently cover costs associated with prescription medications.

The recent downturn of the US economy has led to severe revenue shortfalls for states. The economic downturn has already affected demand on and resources available for ADAPs.

To describe the barriers to access, the numbers and characteristics of clients served, drugs dispensed, and annual funding and expenditure levels of ADAPs, data were collected from 50 States, Puerto Rico, the District of Columbia, Guam, and the Virgin Islands during 2002.

During 2002, about 140,000 clients were served nationwide. In any given month, ADAPs served about 77,000 clients. The Title II ADAP earmark increased from $461m in Fiscal Year (FY) 1999 to $639m in FY 2002. Although both Federal and State funding of ADAPs have grown significantly, many State ADAPs have limited access for new clients.

Learning Objectives:

At the conclusion of the session, the participant (learner) in this session will be able to:
• Describe the cost, services, and demographics of ADAP clients.
• Identify barriers to access for State ADAPs.
• Describe how State run health programs need to prioritize health care services for its uninsured or underinsured population.

Keywords: Access and Services, HIV/AIDS

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.