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

Abstract #69367

Julia Hidalgo, ScD, MSW, MPH¹, John Corea², Ryan Foreman², and Anthony Wutoh, PhD³. (1) Positive Outcomes, Inc., 117 Jordan Taylor Lane, Harwood, MD 20776, (443) 203-0305, julia.hidalgo@positiveoutcomes.net, (2) The Lewin Group, 3130 Fairview Park Drive, Suite 800, Falls Church, VA 22042, (3) Department of Clinical and Administrative Pharmacy Sciences, Howard University School of Pharmacy, 2300 4th Street, NW, Washington, DC 20059

The AIDS Drug Assistance Program (ADAP) funded by the Ryan White CARE Act is a major source of financing of medications for HIV-infected individuals in the US. In Federal Fiscal Year 2002, ADAPs enrolled about 150,000 clients and spent over $954 million. Sharp increases in enrollment and expenditures in recent years have resulted in waiting lists, scaling back of benefits, and other cost cutting measures. This paper presents the results of a study of trends in ADAP enrollment and expenditures and factors contributing to the availability of publicly funded medications for indigent HIV-infected individuals across the US. We review the differences in program design, eligibility criteria, pricing agreements, and cost containment policies adopted by states and their impact on enrollment and expenditures. We present analyses reviewing the highly variable funding available to State ADAPs of other sources of public funding, as well as industry rebates and discounts. Variability of formularies, enrollment and prescription limitations, and sources and levels of funding are presented and their impact on per capita expenditures among states is described. Factors contributing to closing of enrollment and initiation of waiting lists by State ADAPS is discussed, based on multivariate analyses. Challenges in projecting future ADAP expenditures are outlined.

Learning Objectives:

• At the conclusion of the session, the participant in this session will be able to identify factors contributing to trends in ADAP enrollment and expenditures and discuss strategies for supporting future HIV medication financing.

Keywords: HIV/AIDS, Financing

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.