Over the past few years, state AIDS Drug Assistance Programs, or ADAPs, have suffered from government budget cuts. As a result, the programs suffered cutbacks themselves as waiting lists grew, formularies were reduced and enrollments were capped. This past fiscal year has been among the most challenging as the economy stagnates and state HIV testing programs accelerate.
Nonetheless, a new report does offer one bright spot. Between June 2010 and June 2011, drug expenditures fell 8 percent and the average monthly cost per client served by ADAP was $869 in June 2011, representing an 8 percent decrease in average monthly costs per client, according to the National Alliance of State and Territorial AIDS Directors.
Why was there a drop? NASTAD cites a few reasons, including price cuts from drugmakers that resulted from negotiations with the ADAP Crisis Task Force. Drugmakers have been under pressure to lower their prices to the state programs. Last March, for instance, the California State Controller wrote several drugmakers to drop their prices in the face of state budget constraints (see this).
In response to such overtures and the mounting negative publicity, six of eight drugmakers that produce HIV meds began offering more discounts or froze some prices (read here and here). These are forecast to save ADAPs an estimated $142 million from January 2012 through December 2013.
NASTAD adds that health care reform was also helpful, because this mandated an additional 8 percent reduction in rebates. In all, rebates accounted for $619 million of the national ADAP budget, an increase of 16 percent over fiscal year 2010. Other bright spots: the White House freed $35 million for ADAPs and Congress provided a $15 million increase in the current fiscal year funding legislation
Nonetheless, there are more than 4,600 people who remain on ADAP waiting lists to receive access to HIV medications in 12 states. And 23 states have adopted cost-containment strategies, according to NASTAD (you can read the NASTAD report here and view related slides here).