February 2, 2011

February 2, 2011
Some Help for Floridians on ADAP

Welcome to another day in my life. Today is Wednesday and we have almost made it through the middle of another work week. I hope you are having a safe and great week so far while Dab the AIDS Bear and I are on the run.

We finally received some good news about helping some of the Floridians on ADAP. Now this does not solve the problem for everyone on ADAP.

The Fair Pricing Coalition (FPC) today announced that it has brokered agreements that will allow approximately 6,500 Floridians to continue to receive their HIV medications during a budget crisis in that state.

Partners in the agreement include Welvista, a non-profit pharmacy; major manufacturers of HIV medications; and the State of Florida’s AIDS Drug Assistance Program (ADAP).

Florida’s ADAP was expected to exhaust all available funds and shut down in early February if an emergency solution was not implemented. With these agreements, the state of Florida projects having enough funds to provide medications to its remaining 3,500 ADAP clients for the remainder of the ADAP fiscal year (through March 31, 2011).

The plan will be final when the state of Florida and Welvista sign their operational agreement, expected to occur in the next several days.

Under the plan, Florida’s ADAP will transition approximately 6,500 of their nearly 10,000 active clients to Welvista beginning February 14, 2011. Welvista will provide up medications to these clients as a “transition” to the next ADAP fiscal year which begins April 1, 2011, when Florida’s renewed allocation of federal Ryan White/ADAP funds becomes available. Clients will then again receive their medications from Florida’s ADAP program.

Abbott Laboratories, Bristol-Myers Squibb (BMS), Gilead Sciences, Merck and Co., Tibotec Therapeutics and ViiV Healthcare already participate with Welvista to expedite access to HIV medications for ADAP clients on waiting lists.

Abbott, BMS, Gilead and Merck have agreed to participate in the plan brokered by the FPC and will provide medications to Welvista for these additional clients in Florida on a one-time, emergency basis. The FPC is still negotiating with Tibotec Therapeutics about this situation.

“None of us are happy with the Florida fiasco,” remarked Lynda Dee, spokesperson for the FPC. “It will result in a drain on limited funds from drug company patient assistance programs (PAPs). This inequitable use of industry PAPs could have a very significant, negative impact on the ability of other patients from other states to utilize these PAPs,” Dee warned.

“We are nonetheless grateful to the companies and Welvista for their willingness to step in to provide medications for Florida patients,” said Dee. “We clearly recognize this is a one time, emergency rescue of a program that cannot be repeated or duplicated by Florida or any other state. We therefore implore the federal government and all state governments, especially Florida, to provide adequate funding to state ADAPs to meet the medication needs of its uninsured and underinsured people living with HIV,” she concluded.

Nationally, state ADAPs are situated in the eye of a “perfect storm.” Thousands continue to enroll in state ADAPs each year due to the effects from the economic recession, and other factors are contributing additional pressure. These include rising drug prices on already expensive medications (some companies have agreed to price freezes for ADAPs while others continue to take price hikes, limited by law for ADAPs to be no more than the rate of inflation); minimal increases in federal appropriations (the federal ADAP contribution has shrunk from approximately 70 percent to 50 percent of the overall national ADAP budget in recent years) and significant state budget cuts; and larger client caseloads due to HIV positive individuals living longer. Positive developments such as national efforts to significantly expand HIV testing and linkages into care and new HIV treatment guidelines calling for earlier therapeutic treatments have further pushed ADAPs to a fiscal tipping point from which recovery will be difficult.

The National Alliance of State and Territorial AIDS Directors (NASTAD) reports that as of January 27, 2011, there are 5,779 individuals on ADAP waiting lists in ten states.

Twenty states have instituted, or anticipate instituting cost containment measures other than ADAP waiting lists before the end of the ADAP fiscal year ending in March 2011.

Florida has the greatest number of individuals on its waiting list (3,008) which will continue into the next fiscal year. Those individuals are, for the most part, already receiving medications through other pharmaceutical patient assistance resources, and are not affected by this plan. To see a list of states with access restrictions, please visit NASTAD’s website at www.NASTAD.org.

The FPC remains concerned about the fiscal health of Florida’s and many other state ADAPs. Moving forward, the FPC will work with local advocates to push Florida for additional state appropriations and to seek drug rebates that should have been applied for heretofore. In addition to working on this stopgap measure to ensure uninterrupted medications for 6,500 Floridians, the FPC will also continue to work with all stakeholders and ADAPs on long term solutions to the national ADAP crisis.

About the Fair Pricing Coalition (FPC): The FPC is a group of community treatment activists advocating for fair and sustainable pricing of HIV and viral hepatitis drugs in the United States. The FPC also works with manufacturers of HIV medications to ensure adequate co-pay and patient assistance programs are in place to help ensure all Americans living with HIV have access to life saving medications. For more information, visit www.fairpricingcoalition.org.

About Welvista: For over 17 years, Welvista, a nonprofit organization located in Columbia, South Carolina, has been providing access to prescription medications to the uninsured and underserved throughout South Carolina. Welvista partners with 12 branded pharmaceutical companies who donate medications and a network of over 3,000 health care providers, making them one of the largest mail order pharmacies for the uninsured in the nation. In 2009, Welvista filled and dispensed more than 135,000 prescriptions to the uninsured valued at over $47 million. With a grant from the Heinz Family Philanthropies and Abbott Laboratories, Welvista began serving ADAP waiting list clients as part of its mission in August, 2010. For more information, visit www.welvista.org.

So now you have more of the picture of what is going on here in Florida. Until we meet again; here's wishing you health, hope, happiness and just enough.

big bear hug,

Daddy Dab