March 22, 2005

AIDS Action Proposes to Enhance, Streamline, and Modernize AIDS Drug Assistance Program in Next Ryan White CARE Act Reauthorization

(Washington, DC) As Congress moves toward reauthorization of the Ryan White CARE Act, AIDS Action is releasing a plan today recommending changes to this legislation, the largest federal source of discretionary funding for domestic HIV programs and services. As proposed, the plan—Streamlining and Modernizing the AIDS Drug Assistance Program (ADAP) of the Ryan White CARE Act—accomplishes the following:

In doing so, the plan ensures that low-income HIV positive people have consistent and ongoing access to life-prolonging medications no matter where they reside, while also improving the program’s efficiency at a manageable cost.

“Bold action is required to ensure that the quality and availability of HIV care through ADAP keeps pace with the epidemic, ,” states Craig E. Thompson, Chair of the AIDS Action Council Board. “AIDS Action has proposed a plan to end the ADAP crisis and create a national standard of care and treatment for all Americans living with HIV/AIDS.”

He continues, “In the United States today, half a million HIV positive individuals are not yet receiving regular medical care. This year’s CARE Act reauthorization provides us an opportunity to improve our current system of care, including access to drug treatment. If we don’t act now, we’ll face worse problems and more infections five years from now, when the next reauthorization is scheduled.”

The development of effective medications for the treatment of HIV and AIDS-defining illnesses is one of the great success stories in efforts to end the domestic epidemic. As a result of such medications, HIV positive people are leading longer, more productive lives. In the United States today, there are over one million people living with HIV infection. Of this population, more than 125,000 access medications through their state-managed AIDS Drug Assistance Program, and this need for ADAP services is destined to grow over the foreseeable future.

One clear sign of this growing need is that many states have restricted enrollment, eligibility, or medications in their respective ADAPs. To contain costs, almost half the states have been forced since 1993 to cap their ADAP enrollments, limit formularies (state-approved lists of drugs), or modify financial eligibility requirements; thereby reducing the number of individuals receiving medications through the program. In addition, eight states which have not yet imposed such restrictions anticipate implementing cost containment strategies in the upcoming fiscal year. However, these strategies as well as the variability of medications availability and services from state-to-state, cost patients’ health and lives—a problem AIDS Action’s plan seeks to remedy.

AIDS Action is mindful of the need for cost savings. The plan achieves greater efficiency through the creation of a baseline drug formulary, and it achieves cost savings through the use of the Federal Ceiling Price for medications. AIDS Action estimates that modernized and managed growth of ADAP, as outlined in the plan, will cost $1.5 billion in fiscal year 2006, with annual increases of $100 million through fiscal year 2010.

In addition, the plan addresses the need for more Congressional oversight by moving ADAP into its own separate title of the CARE Act, Title V, which will make it easier to monitor the program’s success. The plan further stipulates that ADAP will provide greater accountability to Congress by ensuring the systemic implementation of health-outcome measurements. These measurements include CD4 counts, viral load tests, and other health indicators.

“In responding to the growing need for expensive HIV medications, we must be mindful of how efficiently we are using scarce resources,” AIDS Action Executive Director Marsha A. Martin, DSW states. “AIDS Action’s plan to streamline and modernize ADAP will not only provide for a superior system of care, it will also provide Congress with a better understanding of where our federal response is succeeding,” she adds.

A number of congressional leaders are already familiar with the plan. AIDS Action will continue to educate Congress about ADAP’s current challenges and inform its membership of the solutions outlined in Streamlining and Modernizing the AIDS Drug Assistance Program (ADAP) of the Ryan White CARE Act, available at http://www.aidsaction.org.

AIDS Action strives to end the HIV epidemic by advancing public policies that prevent new infections, provide care for people living with HIV, and support the search for a cure. AIDS Action serves as the national voice for people living with HIV and represents AIDS service organizations, health departments, and a diverse network of community-based organizations across the country.