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National Information Center on Health Services Research and Health Care Technology (NICHSR)

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Introduction to Health Services Research : A Self-Study Course

Case 5: HIV/AIDS, the AIDS Drug Assistance Program (Page 2 of 38)

Case Background

CARE Act, Title II, AIDS Drug Assistance Programs Background

Funded under Title II of the CARE Act since 1990, (Kates, 2004) the AIDS Drug Assistance Programs (ADAPs) are designed to be the HIV/AIDS prescription drug “payer of last resort, the ‘net’ which catches people as they fall through the larger U.S. health care system” (Kates, 2006). Nationwide, 134,000 HIV-positive Americans rely on ADAPs to provide HIV/AIDS drugs, (Draft White 2006) though individual states administer their own programs, and eligibility criteria and approved drugs vary from state to state(Krisberg, 2006).

Problem of Rising Costs and Lack of Funds

Since its inception, ADAP funding has not kept up with the rising costs of the prescription drugs it covers. Some states have been forced to implement cost-containment measures (Kates, 2004). For instance, as of February 2006 nine states had waiting lists and eight additional states put restrictions on covered drugs or tightened eligibility requirements. (ADAP Watch).

Current Funding Issues

Funding for FY 2007 proposes an increase in funding for the CARE Act of $95 million, $70 million of which will be slated for ADAP (Kates, 2006). However, even this increase will not be enough to eliminate state ADAP waiting lists, (Krisberg, 2006) and seven additional states and the U.S. Virgin Islands anticipate being forced to implement cost-containment measures. (ADAP Watch)

This case will help you think about answering questions on HIV/AIDS drug therapy and HIV/AIDS drug assistance programs (ADAP) in an era of reduced funding and on highly active antiretroviral therapy (HAART) - and when it is appropriate to begin this therapy.

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