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ADAP Pill Box: All Things ADAP
The ADAP Advocacy Association (aaa+) is pleased to share its April 2011 edition of the "ADAP Pill Box" - a monthly e-publication focusing entirely on issues relating to the AIDS Drug Assistance Programs ("ADAPs"). aaa+ invites you to share the ADAP Pill Box by forwarding it to your friends and colleagues, and encouraging them to join the aaa+ list-serve on our our website. Tell them that our individual membership is free. Also, please feel free to forward appropriate ADAP-related news items to info@adapadvocacyassociation.org so that we can include them in the next edition.
This month, ADAP stakeholders learned the value of a targeted, consistent message aimed at leveraging grassroots relationships with lawmakers from both political parties. As the President and Congress engaged in an exercise of brinkmanship on who was the better "anti-deficit spender" with many domestic discretionary programs being cut, most HIV/AIDS-related programs were sparred, and the AIDS Drug Assistance Program actually received a sizable increase! In what can be described as a very bleak year for many ADAP stakeholders fighting to protect access to care and treatment for people living with HIV/AIDS, $48 million more in federal ADAP funding was a victory worth celebrating.
After Congress voted to approve the funding, Rep. Alcee Hastings (D-FL) - who was instrumental during this process - issued the following statement:
"In providing $883 million for our nation's ADAP in the full-year Continuing Resolution, Congress has renewed its commitment to combating HIV/AIDS. This funding, which represents an increase of $48 million over last year, will bring much-needed relief to low-income individuals living with HIV/AIDS who are waiting for antiretroviral treatment and other related services. I would like to take this opportunity to thank my dear friends and colleagues from Florida, Congresswoman Debbie Wasserman Schultz, Congressman Ted Deutch, and Congresswoman Frederica Wilson, for their continued support of ADAP and other HIV/AIDS programs. In addition, I would also like to thank Congressman Denny Rehberg, Chairman of the House Appropriations Subcommittee on Labor and Health and Human Services, for his support of this effort. Finally, I commend my friends at AIDS Healthcare Foundation for their leadership and all that they continue to do each and every single day on behalf of people living with HIV/AIDS. Ensuring access to treatment remains key to combating HIV/AIDS. By coming together in support of ADAP, we help ensure that states like Florida can provide low-income individuals living with HIV/AIDS access to the treatment they need to stay alive, stem the tide of new infections, and invest in our nation's long-term fiscal health. However, our work is far from over. According to the National Alliance of State and Territorial AIDS Directors (NASTAD), 7,885 individuals currently remain on ADAP 'waiting lists' in 11 states and thousands more continue to be denied program eligibility due to service cuts. Alarmingly, my home state of Florida accounts for the majority of these cases with 3,807 individuals on the list. We can and must do better for individuals living with HIV/AIDS in this country. It is unconscionable that, in 2011, a lack of program funding remains a significant barrier to treatment. If we can create a no-fly zone in Libya, we should be able to make a 'no-AIDS zone' here in the United States."
ADAP stakeholders need to continue to cultivate relationships with lawmakers, if our recent legislative victory is going to be repeated in years to come.
In preparation for the ongoing effort to secure adequate federal funding, aaa+ - together with its Lead Sponsor the AIDS Healthcare Foundation ("AHF") - in partnership with the Community Access National Network ("CANN") and Housing Works, is hosting its 2011 Annual Conference on Tuesday, July 5th - Thursday, July 7th, 2011. This summit, themed "AIDS DRUG ASSISTANCE PROGRAM Crisis: When will Washington come to the rescue?," will be open to all ADAP stakeholders nationwide. The conference is being held at the Westin Washington DC City Center, located at 1400 M Street, NW, Washington, DC 20005. To make your reservations, please CLICK HERE.
The purpose is to identify key action steps to secure additional federal appropriations, programmatic reforms, and available public and private resources to alleviate the ongoing cost-containment strategies that are putting thousands of people living with HIV/AIDS on ADAP wait lists or program disenrollment.
Faced with the "Perfect Storm" that is being fueled by high unemployment, record number of uninsured, state budgetary cutbacks, high cost of medications and inadequate federal funding, there are a historic number of people being denied access to treatment. Without intervention from either the executive or legislative branch, several thousand people living with HIV/AIDS will be at risk of developing Opportunistic Infections ("OIs"), and thousands of others who are HIV-negative will be at greater risk of contracting the virus because their HIV- positive counterparts are more infectious when not taking Highly Active Anti-Retroviral Therapy ("HAART"). The conference provides an excellent opportunity to demonstrate the proven Return on Investment ("ROI") of ADAPs.
So, please remember to register today for our 4th Annual Conference!
The ADAP Advocacy Association will continue to monitor the ongoing ADAP crisis. Thanks for your ongoing interest and support!
Brandon M. Macsata, CEO
ADAP Advocacy Association (aaa+)

INSIDE THIS ISSUE
NATIONAL: NASTAD Releases April 22, 2011 ADAP Watch
NATIONAL: AHF to Oppose Drastic State AIDS Cuts at April 25th Hearing
NATIONAL: Gilead U.S. AIDS drug sales fall short of estimates
NATIONAL: Gilead "Do the Right Thing" AIDS Postcards & Newspaper "Sticky Notes" Ads Hit Hometown
NATIONAL: ADAP Advocacy Association Praises Bipartisan Congressional Funding for AIDS Drug Assistance Programs in Final Fiscal Year 2011 Budget; Additional $48 Million will Alleviate Growing ADAP Waiting Lists
NATIONAL: Welvista Concludes Florida ADAP Bridge Program
NATIONAL: The Adoption of Mental Health Drugs on State AIDS Drug Assistance Program Formularies
NATIONAL: Massive Proposed Cuts to HIV/AIDS Programs Rejected; AIDS Drug Program Receives $48 million Increase
NATIONAL: Gilead Sciences Raises Price Of Top Selling Products
STATE - Illinois announces reduced access to HIV Medication Assistance, Effective July 1
STATE - Federal report alleges Florida mismanaged AIDS Drug Assistance Program funds
STATE - ADAP cuts draw fire
STATE - AFC Urges Governor, General Assembly to Reverse Decision in the Interest of Public Health
STATE - Thousands could be dropped from state HIV drug-assistance program
STATE - Ohio Issues Notice of Public Hearing to restrict ADAP eligibility
STATE - Panel votes to fund AIDS drugs for poor
STATE - AIDS foundation funding promotes treatment in South
STATE - State health officials could limit newcomers to AIDS drug program to deal with $19.2 million shortfall
Blogs of potential interest

NATIONAL NEWS...
NASTAD Releases April 22, 2011 ADAP Watch
April 22, 2011
The National Association of State & Territorial AIDS Directors (NASTAD) released its newest April 2011 edition of ADAP Watch. As of April 22nd, there were 7,674 individuals (up 121 individuals from 7,553 individuals last month) on ADAP waiting lists in elevan states - including 63 individuals in Arkansas, 3,705 individuals in Florida, 1,384 individuals in Georgia, 11 in Idaho, 685 individuals in Louisiana, 25 individuals in Montana, 194 individuals in North Carolina, 357 individuals in Ohio, 616 individuals in South Carolina, 630 individuals in Virginia and 4 individual in Wyoming. Presently, 94.8% of the ADAP waiting list patients reside in the south. Eighteen ADAPs, 10 with current waiting lists, have instituted additional cost-containment measures since April 1, 2009 (reported as of April 13, 2011). In addition, 14 ADAPs, including four with current waiting lists, reported they are considering implementing new or additional cost-containment measures by the end of ADAP's current fiscal year (March 31, 2012).
Read ADAP Watch - April 22, 2011

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Tallahassee: AHF to Oppose Drastic State AIDS Cuts at April 25th Hearing
AIDS Healthcare Foundation
April 22, 2011
READ AHF PRESS RELEASE
AHF Urges Community to Help Save Florida AIDS Patients and Save ADAP!
FT. LAUDERDALE, Fla.--(BUSINESS WIRE)-- Beginning Monday April 25th the Florida Department of Health is conducting four public hearings on proposed reductions to the eligibility threshold to Florida's AIDS Drug Assistance Program (ADAP), AIDS Insurance Continuation Program (AICP), Housing Opportunities for Persons with AIDS (HOPWA), and possibly other Ryan White funded programs and services. The first of these forums will take place Monday April 25 in Tallahassee (1pm - 4pm, Betty Easley Conference Center, 4075 Esplanade Way, Room 166, Tallahassee, 32399). AIDS Healthcare Foundation (AHF) is spearheading a statewide campaign to get concerned members of the community out to these meetings to help save Florida AIDS patients and save lifesaving programs and services for low-income Floridians. The hearings, known as "Rule 64D" hearings or meetings for the Florida State Department of Health rule governing delivery of such care and services, are likely to be well-attended by concerned AIDS patients and community members from around the state.
In particular, the AIDS Healthcare Foundation will vehemently oppose Florida officials' proposal to reduce the eligibility threshold for many of the state's lifesaving AIDS programs from the current income eligibility requirement: 400% of Federal Poverty Level (FPL) down to 200% FPL - a move that might appear to save the state some money in the short term; however, one that would also cut thousands of vulnerable Floridians off from lifesaving HIV/AIDS care and services and ultimately lead to far higher medical costs to the state as these AIDS patients became ill and sought more expensive emergency care at hospitals around the state.
Florida - with nation's third largest HIV/AIDS caseload -has placed 3,807 HIV/AIDS patients on a waiting list to access its AIDS Drug Assistance Program (ADAP), a federal/state program that helps provide lifesaving AIDS drugs to low-income Americans. This accounts for more than half of the nationwide total of people on ADAP waiting lists. (As of April 15 there were 7,885 people in need of HIV/AIDS medications on ADAP waiting lists in eleven states.)
"Unfortunately, many vulnerable HIV/AIDS patients throughout Florida may become permanently ineligible for continuation of lifesaving services if state officials succeed in changing the current income eligibility requirement for programs like ADAP," said Michael Kahane, Southern Bureau Chief for AIDS Healthcare Foundation. "On paper and given the financial crisis affecting Florida, an eligibility reduction from 400% of Federal Poverty Level down to 200% seems like it might not be that drastic at first blush; however, when you drill down, you find that a single Floridian living with AIDS earning anything more than $21,780 per year would no longer qualify for any assistance whatsoever. Hundreds of Florida AIDS patients could immediately be disenrolled from ADAP and other programs. These patients' drugs and drug regimens can cost $12,000 to $15,000 per year - so these newly ineligible patients might face drug costs that are easily more than half of their income. In light of this, AHF insists that Florida keeps its eligibility threshold at 400% of Federal Poverty Level."
The 2011 Federal Poverty Level income for a single individual living in one of the 48 contiguous states or the District of Columbia is $10,890. 200% of the 2011 FPL would be an income of just $21,780; 300% - $32,670; 400% of FPL - the current eligibility threshold in Florida?is $43,920.
Florida's proposed changes to Rule 64D-4 could have detrimental effects on eligibility for these programs:
ADAP (AIDS Drug Assistance Program)
AICP (AIDS Insurance Continuation Program)
HOPWA (Housing Opportunities for People with AIDS)
Co-Pay Assistance
Nationwide, ADAPs serve over 165,000 people, accounting for one third of people on AIDS treatment in the U.S. Unfortunately, the need for these programs expands every year, as more and more people become infected and diagnosed with HIV/AIDS; each year thousands of newly diagnosed HIV patients turn to ADAPs because they cannot afford their medicines.
AIDS Healthcare Foundation (AHF), the largest global AIDS organization, currently provides medical care and services to more than 157,000 individuals in 26 countries worldwide in the US, Africa, Latin America/Caribbean, the Asia/Pacific region and Eastern Europe. www.aidshealth.org.
In FLORIDA, AHF serves more than 15,000 Floridians living with HIV/AIDS through a variety of programs, including free HIV testing and prevention programs; HIV/AIDS health care centers located in Ft. Lauderdale, Miami and Jacksonville, eight AHF Pharmacies located throughout the state, a statewide disease management program; and its Positive Healthcare Managed Care program.
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Source: AIDS Healthcare Foundation press release

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Gilead U.S. AIDS drug sales fall short of estimates
Reuters | By Deena Beasley
April 20, 2011
READ STORY
(Reuters) - Gilead Sciences Inc's (GILD.O) first-quarter profit fell a deeper-than-expected 24 percent as U.S. state-funded purchases of its core AIDS drugs were lower than expected and royalty revenue slipped.
The company's shares dropped more than 3 percent in after-hours trading.
Sales of HIV drug Truvada rose 2 percent to $673.1 million, while sales of Atripla rose 7 percent to $744.5 million -- but the totals fell short of respective average analyst estimates of $688 million and $793 million.
Gilead said U.S. sales were hit by temporary cutbacks at state-funded AIDS drug assistance programs (ADAPs) in Florida and Texas.
"Investors will want clarity on whether this is indicative of a longer-term trend," said Cowen & Co analyst Phil Nadeau. "Gilead did maintain its full-year guidance, which suggests that this is not an ongoing problem."
The company still expects full-year product sales of between $7.9 billion and $8.1 billion.
"We believe that the fundamentals of our business remain strong with regard to patient demand and prescription growth in the retail sector," John Milligan, Gilead's president and chief operating officer, said on a conference call.
The company's quarterly adjusted profit of 87 cents per share fell well below the average Wall Street analyst forecast of 97 cents per share, according to Thomson Reuters I/B/E/S.
Gilead attributed the mismatch between U.S. demand and its sales revenue to budget problems in Texas and Florida, adding that the federal government recently set a fiscal 2011 ADAP budget of $885 million -- up 6 percent from the prior year.
"The very latest intelligence we have gathered at the state level indicates that there is second-quarter purchasing by ADAP programs, including Florida, within the last week," said Kevin Young, head of commercial operations at Gilead.
He said he had not heard about renewed buying by the Texas program.
The company's net income fell to $651.1 million, or 80 cents per share, from $854.9 million, or 92 cents per share, a year earlier.
Total revenue for the quarter fell to $1.93 billion from $2.09 billion a year earlier. Analysts expected $2.04 billion.
Royalty, contract and other revenue fell 79 percent to $62.5 million. Gilead derives most of its royalty revenue from Roche Holding's (ROG.VX) sales of Tamiflu.
Research and development costs rose to $254.4 million from $218.7 million a year earlier.
Gilead shares, which have gained about 11 percent so far this year to close at $40.78 on Wednesday, were trading at $39.40 after hours.

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Gilead "Do the Right Thing" AIDS Postcards & Newspaper "Sticky Notes" Ads Hit Hometown
AIDS Healthcare Foundation
April 20, 2010
AIDS Healthcare Foundation Campaign Targets Neighborhood of Gilead Headquarters, Seeks to Educate Gilead Employees & General Public About High Price of Gilead's AIDS Drugs for Cash-Strapped State AIDS Drug Assistance Program (ADAP) With Innovative Use of Newspaper "Sticky Notes" Ads
Prices for Company's Key AIDS Drugs, Such as Atripla - Priced at $10,000 per Patient per Year for ADAP - Limit Access to Lifesaving Drugs for Neediest Americans
READ PRESS RELEASE
SACRAMENTO, CA (Marketwire - April 20, 2011) - AIDS Healthcare Foundation (AHF) launched a campaign to educate employees and neighbors of Gilead Sciences, Inc. over the high price of its key AIDS drugs, such as Atripla, which are putting a strain on state cash-strapped AIDS Drug Assistance Programs (ADAPs). ADAP is the payer of last resort for low-income Americans who cannot afford their HIV medicines. The campaign includes postcards sent to residents of neighborhoods surrounding the company's headquarters in Foster City, California -- including Foster City, Hillsborough, Atherton, Redwood City and El Granada in San Mateo County, and Oakland in Alameda County. The postcards feature the image of a red AIDS ribbon, along with the message: "Gilead, Do the Right Thing!" and refers the public to www.2gilead.org for more information and to send an e-letter expressing concern to Gilead CEO John C. Martin.
In addition, AHF has employed an innovative use of newspaper front-page "sticky notes." These 3" x 3" removable stickers are usually pasted over the masthead of a newspaper and are most often utilized as somewhat intrusive sales and marketing tactic to sell products that face stiff competition such as insurance, auto sales and lap-band surgery. To AHF's knowledge, this is the first time this marketing tactic is being employed to further an advocacy-related goal, not sell a product or service. AHF's "sticky notes" feature the same image as the postcards, the message "Gilead, Do the Right Thing!" and the website: www.2gilead.org. These ads will target similar neighborhoods to the postcards and are scheduled to appear on the front pages of the San Mateo County Times and the San Jose Mercury News beginning on April 20th and on the San Francisco Chronicle beginning on May 9th.
"AHF's 'Do the Right Thing' campaign targeting Gilead is designed to bring the message about the company's unreasonably high prices for Atripla and other AIDS drugs directly to company employees and neighbors," said Michael Weinstein, AHF President. "Employees and the public should know about the company's pricing and policies on the company's AIDS drugs and the negative impact those prices are having on access. Gilead has generated billions in revenue from ADAP and now it's time for them to step up. Thousands of lives are depending on it."
With state budgets stretched thin and increasing numbers of unemployed workers without health insurance, many states have been forced to cap enrollment in their AIDS Drug Assistance Programs. Currently, there are 7,700 individuals on waiting lists to receive lifesaving AIDS medications in eleven states. Hundreds of patients in need are being added to the waiting list each week. In addition, thousands more Americans living with HIV/AIDS have been dropped from the program or made ineligible to receive medications through ADAP due to stricter eligibility requirements.
HIV/AIDS medications manufactured by Gilead represent the largest share of drugs paid for by ADAP.
In recent weeks, both California State Treasurer Bill Lockyer and California State Controller John Chiang have written letters urging Gilead to reduce the price of their HIV/AIDS medications for California's AIDS Drug Assistance Program. In addition to their roles as State officials, Lockyer and Chiang are also Board Members for CalSTRS and CalPERS, the two largest public pension funds, both of which are substantial shareholders in Gilead.
In his letter to Gilead, Treasurer Lockyer stated: "Year in and year out, the increasing cost of AIDS drugs has limited the number of people who can be served using existing ADAP funds. For example, California's ADAP program (the largest in the nation) has experienced a 257% increase in AIDS drug spending since 2000, more than three times the rate of client growth over this same period... These increases not only place an undue burden on people seeking treatment, but place an unsustainable burden on states. California cannot afford to increase the budget for ADAP indefinitely in order to pay for higher drug prices."
AIDS Healthcare Foundation has previously reached out to Gilead urging the company to lower ADAP prices. In a letter to the company's CEO John C. Martin, dated February 2, 2011, Mr. Weinstein urged a 20% price cut: "A 20% price reduction (or rebate in applicable states) will enable ADAPs to provide lifesaving treatment to all those who need it. Moreover, this discount will have negligible impact on your company's revenue from the ADAP program. ADAP budgets for purchasing drugs are fixed -- as evidenced by the waiting lists -- which means that drug companies will receive all of the money available to the program regardless of pricing. The only question is, given the cost of drugs, how many people ADAPs will be able to serve with this set pot of funds."
Mr. Martin's response letter referred to previous efforts Gilead has made through its own Patient Assistance Program, saying: "For patients who meet eligibility criteria for this program, Gilead will pay up to $200 per month ($2,400/year) toward out-of-pocket expenses for our HIV medications starting at $0."
Added Weinstein: "'Patient Assistance Programs' are an inadequate substitute for a functional ADAP program. We hope that Gilead will hear the important message that AHF is sending on behalf of Americans living with HIV/AIDS and will do the right thing for patients in need by lowering prices immediately."
AIDS Healthcare Foundation (AHF), the largest global AIDS organization, currently provides medical care and services to more than 156,000 individuals in 26 countries worldwide in the US, Africa, Latin America/Caribbean the Asia/Pacific region and Eastern Europe. www.aidshealth.org.
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Source: AIDS Healthcare Foundation press release

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ADAP Advocacy Association Praises Bipartisan Congressional Funding for AIDS Drug Assistance Programs in Final Fiscal Year 2011 Budget; Additional $48 Million will Alleviate Growing ADAP Waiting Lists
ADAP Advocacy Association
April 15, 2011
READ PRESS RELEASE
WASHINGTON, DC (April 15, 2011) - The ADAP Advocacy Association, also known as aaa+, today praised the bipartisan Congressional support for the additional $48 million included in the final Fiscal-Year ("FY") 2011 budget for the AIDS Drug Assistance Program ("ADAP"). The budget provides $885 million for ADAP, which is $25 million more than was obligated in FY10, after the President's mid-year emergency $25 million transfer to address waiting lists. The bill provides $8 million more than the original budget introduced in the House of Representations (H.R.1).
"Yesterday's bipartisan vote in the U.S. House of Representatives and U.S. Senate was a grassroots victory for every American living with HIV/AIDS who has been fighting for timely access to care and treatment since the current ADAP crisis started," said Brandon M. Macsata, CEO of the ADAP Advocacy Association. "Despite their partisan differences on many issues, ADAP's unquestionable Return on Investment for the taxpayer demonstrated that bipartisanship still exists in Washington. The additional $48 million included in the budget will help to alleviate the growing ADAP waiting lists across the country. But more work needs to be done!"
ADAPs provide life-saving medications to people living with HIV/AIDS nationwide who are uninsured or under-insured. This vital federal-state program has faced a budget shortfall for the last several years, resulting in waiting lists. As of April 8, 2011, there 7,900 people living with HIV/AIDS on ADAP waiting lists - including Arkansas (51 people), Florida (3,967 people), Georgia (1,328 people), Idaho (10 people), Louisiana (861 people), Montana (22 people), North Carolina (138 people), Ohio (326 people), South Carolina (597 people), Virginia (597 people) and Wyoming (3 people) - with 20 ADAPs, including eleven with current waiting lists, reported they are considering implementing new or additional cost-containment measures by the end of ADAP's current fiscal year (March 31, 2011).
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Source: aaa+ press release

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Welvista Concludes Florida ADAP Bridge Program
Welvista Pharmacy
April 14, 2011
READ PRESS RELEASE
COLUMBIA, SC (April 14, 2011) - Welvista announced today it filled 10,267 prescriptions for 5,403 HIV patients in Florida during a six-week period during which the South Carolina-based non-profit served as a bridge for the state's tapped-out AIDS Drug Assistance Program.
Welvista and the five supporting pharmaceutical manufacturers provided $23,845,427 in medications for the Florida Bridge Program: Abbott, BMS, Gilead, Merck, and ViiV partnered directly with Welvista in the Florida bridge program. Tibotec participated in the program through a different venue.
April 1, 2011, Florida resumed providing medications to its estimated 10,000 patients which includes the 5,403 patients who were served by Welvista in the bridge program.
"Like many states, Florida was dealing with serious budget shortfalls that were impacting a variety of essential social services," Welvista CEO Ken Trogdon said. "Thanks to our funders like the Heinz Foundation and our partnerships in the pharmaceutical industry, Welvista was positioned to step in and ensure that thousands of uninsured HIV patients continued to receive their essential medications. This averted a tragic health crisis that could have had far-reaching consequences. We remain very concerned about the number of under- and uninsured who are at risk of losing essential assistance as a result of the deepening budget crises across the nation, and we will continue to work with our partners to develop the kind of sustainable solutions that will help address these needs while providing significant savings for healthcare providers."
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. Meanwhile, a litany of factors is combining to further squeeze these state programs:
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.
Significant state budget cuts.
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 April 1, 2011, there are more than 7,900 individuals on ADAP waiting lists in 11 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.
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. Abbott Laboratories, Bristol-Myers Squibb (BMS), Gilead Sciences, Merck and Co., Tibotec Therapeutics, and ViiV Healthcare participate with Welvista to expedite access to HIV medications for ADAP clients on waiting lists in 11 states, including Florida.
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Source: Welvista Pharmacy press release

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Adoption of Mental Health Drugs on State AIDS Drug Assistance Program Formularies
National Center for Biotechnology Information
April 14, 2011
READ ABSTRACT
Objectives. We sought state-level factors associated with the adoption of medications to treat mental health conditions on state formularies for the AIDS Drug Assistance Program. Methods. We interviewed 22 state and national program experts and identified 7 state-level factors: case burden, federal dollar-per-case Ryan White allocation size, political orientation, state wealth, passage of a mental health parity law, number of psychiatrists per population, and size of mental health budget. We then used survival analysis to test whether the factors were associated with faster adoption of psychotropic drugs from 1997 to 2008. Results. The relative size of a state's federal Ryan White HIV/AIDS Program allocation, the state's political orientation, and its concentration of psychiatrists were significantly associated with time-to-adoption of psychotropic drugs on state AIDS Drug Assistance Program formularies. Conclusions. Substantial heterogeneity exists across states in formulary adoption of drugs to treat mental illness. Understanding what factors contribute to variation in adoption is vital given the importance of treating mental health conditions as a component of comprehensive HIV care. (Am J Public Health. Published online ahead of print April 14, 2011: e1-e7. doi:10.2105/AJPH.2010.300100).

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Massive Proposed Cuts to HIV/AIDS Programs Rejected; AIDS Drug Program Receives $48 million Increase
The AIDS Institute
April 12, 2011
READ ARTICLE
Washington, DC - "We congratulate the Congress and the Obama Administration for rejecting many of the massive cuts to domestic and global HIV/AIDS programs that were initially proposed by Republicans in the House of Representatives. While most of these programs will experience some reductions, they will be spared from the reckless cuts which would have had serious long term impacts on the health and wellbeing of people living with HIV/AIDS and on efforts to prevent HIV infections in the future," commented Carl Schmid, Deputy Executive Director of The AIDS Institute.
The final federal spending bill for Fiscal Year 2011 proposes to increase funding to the AIDS Drug Assistance Program (ADAP) by $48 million. "We are very appreciative of this increase, which demonstrates a real bipartisan commitment to the program. But, with 8,000 people in eleven states on waiting lists and thousands more already removed from the program, this is far from what is currently required and meet the growing number of new people needing ADAP medications in the coming year," added Schmid.
ADAPs provide medications to about one in four HIV positive people in care in the U.S. and the demand for the program has skyrocketed due, in part, to people losing their health insurance. Over the course of one year, the federal government documented an increase of over 30,000 new people to the program. "The ADAP crisis is far from over and will only be exacerbated with federal and state cuts to Medicaid as ADAP and the rest of the Ryan White Program will have to pick up those costs," said Schmid. The other parts of the Ryan White Program, which provide the necessary health care and support services for people living with HIV/AIDS, would see no increases in FY11, and instead be cut .2% at a time when patient loads are growing.
The final bill negotiated between the House, the Senate and the Obama Administration not only rejected many proposed program terminations and cuts but also most policy riders. "We are pleased that the Congress rejected the House Republican proposed federal and District of Columbia funding bans on syringe exchange programs. These programs are scientifically proven to be effective in the prevention of HIV and Hepatitis and it would have been devastating if these tools were to be removed due to irrational ideological purposes," said Michael Ruppal, Executive Director of The AIDS Institute.
Ruppal also expressed concern with the cuts to prevention programs at the CDC. "With over 56,000 new HIV infections annually in the U.S., now is not the time to cut CDC's prevention funding," said Ruppal. The bill cuts $730 million from the CDC in areas still yet to be determined. Earlier reports from the House Appropriations Committee indicating an over $1 billion cut to HIV/STD/Hepatitis and TB Prevention programs at the CDC were in error.
The final bill also rejected the following egregious provisions passed earlier by the House of Representatives in HR 1:
Completely defunding Title X family planning programs and prohibiting any funding for Planned Parenthood Federation of America, Inc. and its clinics;
Eliminating all funding of the Prevention and Public Health Fund;
Completely defunding the Teen Pregnancy Prevention Program; and
Defunding implementation of elements of the Patient Protection and Affordable Care Act (although some were included in the final bill).
Sadly, the final bill cuts research funding at the National Institutes of Health by about $300 million. The House Republican bill proposed a cut of over $1.6 billion, including contributions to the Global Fund. Investing in HIV research will help in the discovery of new medications, new tools in the prevention of HIV, including vaccines, and ultimately a cure.
"With the long battle over levels of federal spending for FY11 almost over, we realize that this is just the beginning of efforts to cut government spending and the budget deficit," added Ruppal. "As the President and the Congress address these real problems, The AIDS Institute reminds all parties to not act in haste without first considering the long term human and societal impacts of their decisions. Our government must be responsible with taxpayers' money, but it also must be accountable to the basic human health needs of people," concluded Ruppal.
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The AIDS Institute press release

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Gilead Sciences Raises Price Of Top Selling Products
DOW JONES NEWSWIRE | By Thomas Gryta
April 4, 2011
READ ARTICLE
NEW YORK - (Dow Jones) - Gilead Sciences Inc. (GILD), known for selling HIV drugs, increased the prices of several of its top selling products at the beginning of the month.
The Foster City, Calif., drug maker increased the price of its biggest seller, HIV treatment Atripla, by 5.1%, according to a spokeswoman Monday. Gilead also raised the price of HIV drugs Truvada and Emtriva by 7.9%, and lung disease treatment Letairis by 4.9%.
For the company's HIV products, a price freeze for AIDS Drug Assistance Programs remains in effect, she said.
Cowen & Co. analyst Phil Nadeau said the increases are "consistent in magnitude and timing with Gilead's historical patterns." He said the increases will impact about 60% to 70% of the U.S. market, which is about 60% of Gilead's global sales of HIV drugs.
Gilead reported 2010 total product sales of $7.39 billion with Atripla bringing in $1.9 billion in the U.S.
Truvada had U.S. sales of $1.3 billion last year, while Emtriva had just $16.7 million. Letairis had 2010 sales of $240.3 million.

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ACROSS THE NATION...
Illinois: Illinois announces reduced access to HIV Medication Assistance, Effective July 1
Source: Windy City Times
April 25, 2011
READ STORY
CHICAGO, IL - On April 15, the Illinois Department of Public Health (IDPH) announced plans to restrict access to the AIDS Drug Assistance Program (ADAP) to new applicants with incomes at or below 300 percent of the federal poverty level ($32,670 for a single individual) beginning in July. The current limit to qualify for Illinois ADAP is 500 percent of federal poverty ($54,450 for a single individual).
"This is a sad day for the fight against HIV/AIDS in Illinois," said David Ernesto Munar, President/CEO of the AIDS Foundation of Chicago (AFC). "The new policy will keep ADAP out-of-reach for hundreds of individuals who have nowhere else to turn for help. Many will simply forgo treatment, at great risk to themselves and their partners."
Jointly funded by the federal and state governments, ADAP provides HIV medications each month to more than 4,200 Illinoisans who have no other means to afford their lifesaving medications, which can cost $18,000 or more per year.
To read the entire article, visit http://www.windycitymediagroup.com/gay/lesbian/news/ARTICLE.php?AID=31432.
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Florida: Federal report alleges Florida mismanaged AIDS Drug Assistance Program funds
Source: The Florida Independent | By Marcos Restrepo
April 25, 2011
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FORT LAUDERDALE, FL - A January 2011 federal report provided to The Florida Independent on the condition of anonymity alleges that federal audits and site visits show that Florida's Bureau of HIV/AIDS failed to use "available resources in the best interest of people living with HIV and AIDS" while administering its AIDS Drug Assistance Program, which provides HIV/AIDS medications to low-income citizens.
The state's Bureau of HIV/AIDS manages the AIDS Drug Assistance Program - funded by both the state and federal government - to ensure that uninsured, under-insured or low-income HIV/AIDS patients receive needed medicine and treatment. Florida's AIDS Drug Assistance Program has been in the midst of a funding crisis since last year, which has resulted in a patient waiting list that is the longest in the nation.
To read the entire article, visit http://floridaindependent.com/27984/federal-report-alleges-florida-mismanaged-aids-drug-assistance-program-funds.
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Illinois: ADAP cuts draw fire
Source: Gay Chicago Magazine | By Gary Barlow
April 24, 2011
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CHICAGO, IL - Agreeing with advocates' criticism of cuts in the state's AIDS Drug Assistance Program announced by the Illinois Department of Public Health, an influential state lawmaker said April 22 she'll find "excesses" in other parts of the IDPH budget to reverse the cuts.
"I have found some excesses and other opportunities to possibly cut other parts of the Public Health budget," said state Rep. Sara Feigenholtz (D-Chicago), who chairs the House Appropriations-Human Services Committee.
IDPH said April 15 it intends to restrict access to ADAP to individuals earning 300 percent or less of the federal poverty level, or $32,670 this year. ADAP is currently available to persons earning 500 percent or less of the federal poverty level, about $54,450. The program provides HIV/AIDS medications, which can cost up to $20,000 per year per person, to more than 4,200 people in Illinois.
Non-citizens who rely on the state for food assistance would see their benefits cut by a third, and state funding to help people pay for HIV and AIDS medication would be eliminated.
To read the entire article, visit http://www.nowingaychicago.com/2011/04/adap-cuts-draw-fire.html.
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Illinois: AFC Urges Governor, General Assembly to Reverse Decision in the Interest of Public Health
AIDS Foundation of Chicago
April 15, 2011
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CHICAGO, IL - On April 15, 2011 the Illinois Department of Public Health (IDPH) announced plans to restrict access to the AIDS Drug Assistance Program (ADAP) to new applicants with incomes at or below 300 percent of the federal poverty level ($32,670 for a single individual) beginning in July. The current limit to qualify for Illinois ADAP is 500 percent of federal poverty ($54,450 for a single individual).
"This is a sad day for the fight against HIV/AIDS in Illinois," said David Ernesto Munar, President/CEO of the AIDS Foundation of Chicago (AFC). "The new policy will keep ADAP out-of-reach for hundreds of individuals who have nowhere else to turn for help. Many will simply forgo treatment, at great risk to themselves and their partners."
Jointly funded by the federal and state governments, ADAP provides HIV medications each month to more than 4,200 Illinoisans who have no other means to afford their lifesaving medications, which can cost $18,000 or more per year.
To read the entire article, visit http://www.aidschicago.org/advocacy-home/adap/322--illinois-announces-reduced-access-to-hiv-medication-assistance-effective-july-1.
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Florida: Thousands could be dropped from state HIV drug-assistance program
Tallahassee.com | By Tamaryn Waters
April 23, 2011
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TALLAHASSEE, FL - More than 9600 people statewide currently are getting free medication through the state's AIDS Drug Assistance Program (ADAP) based on income eligibility, but 3800 people are on a waiting list, according to the Florida Department of Health's Bureau of HIV/AIDS. Florida residents living with HIV and AIDS could have a tougher time getting life-saving medication if the state changes who will be eligible for the program.
To read the entire article, visit http://www.tallahassee.com/article/20110423/BREAKINGNEWS/110422008/Thousands-could-be-dropped-from-state-HIV-drug-assistance-program.
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Ohio: Ohio Issues Notice of Public Hearing to restrict ADAP eligibility
Ohio Department of Health
April 20, 2011
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COLUMBUS, OH - The Ohio Department of Health issued a Notice of Public Hearing in accordance with Chapter 119 of the Revised Code (R.C.) and by authority of R.C. 3701.241, the Director of the Ohio Department of Health (ODH), or his designee, will conduct a public hearing at the time and place listed above, to consider the proposal to rescind current O.A.C. rules 3701-44-01 to 3701-44-08; and to file new rules 3701-44-01 to 3701-44-04. These rules pertain to the Ryan White Part B program administered by ODH.
To read the entire public notice, visit http://www.registerofohio.state.oh.us/pdfs/phn/3701_NO_136139_20110420_1518.pdf.
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South Carolina: Panel votes to fund AIDS drugs for poor
The (Charleston) Post and Courier | By Renee Dudley
April 21, 2011
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CHARLESTON, SC - A South Carolina Senate committee voted to pump $5 million into a program that pays for AIDS drugs for the poor - an increase of more than $3 million over last year's funding.
The state Senate Finance Committee's approval of the proposal last week coincided with the release of new figures showing explosive growth of the AIDS Drug Assistance Program's waiting list. As this year's funding for the program dwindles, more than 600 South Carolinians in immediate need of medicine are named on the waiting list for help, said Anand Nagarajan, the state director of the program.
But advocates said the increase still leaves the program, which covers drug costs for about 2,000 residents a month, at a loss.
To read the press release, visit http://www.thesunnews.com/2011/04/21/2113517/panel-votes-to-fund-aids-drugs.html#ixzz1KomWg4NE.
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Georgia: AIDS foundation funding promotes treatment in South
The Augusta Chronicle | By Tom Corwin
April 17, 2011
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AUGUSTA, GA - Last week as the U.S. House of Representatives endorsed plans for deep cuts in funding to health care and domestic programs, officials and advocates in Augusta said there is an even greater need for grassroots groups and public health to work together.
"You have to work with what you have," said Lisa Frederick, the associate director of the HIV Health Literacy Program for AIDS Community Research Initiative of America.
The group partnered with Georgia Health Sciences University to sponsor a two-day training session for health literacy, bringing together various organizations from the community. Using a grant from the Elton John AIDS Foundation, the group has specifically targeted the South, and Augusta in particular, to help foster collaborations, Frederick said.
To read the press release, visit http://chronicle.augusta.com/news/health/2011-04-17/aids-foundation-funding-promotes-treatment-south.
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Texas: State health officials could limit newcomers to AIDS drug program to deal with $19.2 million shortfall
Statesman.com | By Mary Ann Roser
April 1, 2011
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AUSTIN, TX - Scot More of Houston fell ill with HIV in 1989, and by 2002 he had lost everything, including his home. Had it not been for a government program that finances HIV and AIDS drugs for needy people, he would be dead, he told a state advisory panel Friday.
More was not the only Texan who credited the Texas AIDS Drug Assistance Program with saving his life during sometimes impassioned testimony at an Austin hearing before a state advisory panel that is seeking ways to close an anticipated $19.2 million shortfall. Nearly three dozen others in an audience of 100 people living with HIV or AIDS, their advocates and others urged the Texas HIV Medication Advisory Committee to fight for funding.
To read the press release, visit http://www.statesman.com/news/texas-politics/state-health-officials-could-limit-newcomers-to-aids-1368394.html.
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Blogs of potential interest
To Save HIV/AIDS Drugs Funding, Will Sara Feigenholtz and Heather Steans Have the Midas Touch? - Tuesday, April 26, 2011
HIV-Positive Former Inmates Face New Obstacles in Society - Thursday, April 21, 2011
The Epidemic is NOT Over:A Call To Action - Tuesday, April 19, 2011
Federal Government Manages to Spare Money for AIDS Funding Despite Nearly Shutting Down - Wednesday, April 13, 2011
Weekly Pulse: Paul Ryan's Medicare Swindle - Wednesday, April 13, 2011
A Step Forward in Tackling America's AIDS Epidemic (Now the Work Begins) - Tuesday, April 5, 2011
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For further information contact:
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