ADAP Waiting List Update: 35 People in 1 State as of July 23
- There are 35 people on an AIDS Drug Assistance Program (ADAP) waiting list in one state (as of July 23, 2014).
- Eleven ADAPs have had cost-containment measures in place since April 1, 2013 (reported as of July 15, 2014).
- No ADAPs currently anticipate additional cost-containment measures prior to March 31, 2015.
ADAPs With Current or Anticipated Cost-Containment Measures, Including Waiting Lists, as of July 15, 2014
ADAPs With Waiting Lists (35 Individuals in 1 State, as of July 23, 2014)
|State||Number of Individuals on ADAP Waiting List||Percent of the Total ADAP Waiting List||Increase/Decrease From Previous Reporting Period||Date Waiting List Began|
Waiting List Organization: Waiting list clients are prioritized by one of two models:
- First-come, first-served model: placing individuals on the waiting list in order of receipt of a completed application and eligibility confirmation (0 ADAPs).
- Medical criteria model: based on hierarchical medical criteria based on recommendations by the ADAP Advisory Committee (1 ADAP).
Access to Medications: Utah confirms that case management services assist clients in obtaining medications through the HarborPath ADAP waiting list program or pharmaceutical company patient assistance programs (PAPs) while clients are on the waiting list.
Latest ADAP News
The Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies passed their version of the FY2015 Labor-HHS-Education Appropriations bill, which flat funded ADAPs. Though both House and Senate leadership indicated that appropriations would take place under "regular order," the full Senate Appropriations Committee will likely not mark up their version of the bill until after the November elections. There is no House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies markup scheduled and it is now also rumored to be postponed until after the November elections. There will most likely be a short term continuing resolution funding the government until after the November elections. Depending on the outcome of the elections, there may be another continuing resolution until the start of the new Congressional session in January 2015.
ADAPs With Other Cost-Containment Strategies (Since April 1, 2013,i as of July 15, 2014)
|Enrollment Cap||Expenditure Cap||Financial Eligibility||Formulary Reduction||Other|
|Arizona: (monthly: insurance premiums of $350); (annual: medical copayment of $3000)|
South Dakota: (annual)
|Georgia: cap on insurance premiums|
Montana: service reductions in place
ADAPs Considering New/Additional Cost-Containment Measures (Before March 31, 2015ii)
|Enrollment Cap||Formulary Reduction||Waiting List|
In April, Alaska and Louisiana reported anticipating new cost-containment measures. As of the latest ADAP Watch survey, they both no longer anticipate these new measures due to internal system reviews. Alaska was able to keep their formulary unchanged after reviewing their overall utilization data. Louisiana was able to avoid establishing an enrollment cap and wait list due to implementation of a new pharmacy benefit management contract and changes in the state's fiscal review process that has allowed for more efficient and timely rebate processing.
ADAPs That Eliminated/Modified Cost-Containment Measures (Since April 1, 2013iii, as of April 7, 2014)
|Enrollment Cap||Expenditure Cap||Formulary Reduction||Other|
|New Mexico||Utah||Oklahoma: increase financial eligibility to 400% for individuals with insurance; 200% for uninsured.|
Washington: stopped requiring use of PAPs during insurance enrollment