Despite an increase in national funding, Idaho and 10 other states continue to have waiting lists for low-income HIV and AIDS patients (search) who need help paying for prescription drugs, according to a report from the Kaiser Family Foundation and the National Alliance of State AIDS Directors.
"These are lifesaving medications," said Lisejean Freed with the North Idaho AIDS Coalition (search) in Coeur d'Alene. "On my caseload, I have 37 clients in the five northern counties, and probably eight of those people are on a waiting list."
The drugs that slow the advance of HIV and AIDS can cost patients thousands of dollars a month, Freed said. AIDS Drug Assistance Programs (search) nationwide help low-income patients afford the medications, but federal funding is slim. Some states, including Idaho, have been forced to leave patients on a waiting list as health care costs rise.
"As of the end of March, we have 49 clients on the waiting list in Idaho," said Anne Williamson, the STD/AIDS program manager for the Idaho Department of Health and Welfare. Though Idaho got part of a $20 million one-time federal initiative — giving 41 of those patients some temporary access to the drugs — that cash is expected to run out in September, Williamson said.
"Right now, we do not have the funding available to bring those clients into our active program. The funding has not kept up with the demand," Williamson said. "It's very critical. It could mean individuals living with HIV having to go without lifesaving medications."
Idaho only has 92 people participating in the AIDS Drug Assistance Program, Williamson said. To qualify, a person must have AIDS or be HIV-positive and be living at less than 200 percent of the federal poverty level.
That means a person living alone would have to make less than about $19,000 a year, though most of the people on Idaho's drug assistance program make far less. That makes it impossible for them to afford the average $1,300 a month that Idaho AIDS and HIV patients pay for medications alone, Williamson said.
"ADAPs serve as a critical safety net for people with HIV/AIDS in the U.S., filling the gaps in prescription drug coverage," Kaiser Family Foundation Vice President Jennifer Kates said in a prepared statement. "The growing number of people who need HIV medications and rising drug costs continue to exceed available resources."
Other states with waiting lists include Alabama, Alaska, Arkansas, Iowa, Kentucky, Montana, Nebraska, North Carolina, West Virginia and Wyoming.
Idaho has a low rate of HIV infection, with only 740 reported living cases of HIV or AIDS in the state at the end of 2004, according to the state Department of Health and Welfare. But the fact there are few cases may hurt the state's federal funding.
"Funding formulas are based on reported cases of AIDS, and because Idaho is a low-prevalence rural state we don't get large increases when funding is spread nationally," Williamson said. "If Congress is not willing to make the commitment to appropriately fund the program, it will be up to individual states to step up to the plate and do their fair share."
Eight of the clients on Idaho's ADAP waiting list are being provided drugs at low or no cost by the pharmaceutical industry, Williamson said, though she is reluctant to rely on the companies to pick up where ADAP ends.
"Nationally, ADAP underfunding could overburden the patient pharmaceutical assistance program and force them to stop adding new clients, too," she said.
Earlier this month, U.S. Health and Human Services Secretary Mike Leavitt awarded 59 grants worth more than $1 billion to all states and nine U.S. territories for their ADAP programs.
Idaho's 2005 grant was for $965,496. Of that, $500,000 was based on the number of people living with AIDS in Idaho, $581 was allocated to bolster care and services for minorities living with AIDS, and $464,915 will help the 92 people enrolled in the drug assistance program buy AIDS drugs. That works out to about $5,050 per person in the program.
Williamson said the state kicked in $177,500 to ADAP for 2005, but that still won't be enough to cover the entire annual cost of more than $15,000 per person. The state will use some of the $500,000 allocated for direct services to help buy the medications.
In 2003, national ADAP funding totaled $961.5 million. That rose by 11 percent in 2004, allowing 38 programs to provide medication to more people, according to the Kaiser study. But nearly two-thirds of that increase came from increased state spending and drug rebates, and 5 percent came from federal appropriations.