HIV/AIDS patients struggle to afford medications without state program

The AIDS Drug Assistance Program (ADAP), which receives state and federal funds, provides financial assistance to low-income HIV/AIDS patients so they can purchase medications to combat their diseases.

ADAP closed to new applicants on Jan. 22 after losing more than $7 million in state funding.

"The ADAP program is life or death," said John Paul Womble, interim executive director of Alliance of AIDS Services.

State AIDS and STD Director Jacquelyn Clymore said the program's increased enrollment played a part in the decision to close the program to new applicants. The program saw a more than 29 percent increase in enrollment in past two years and a significant boom in last six months of 2009.

Clymore said the decision was made because the program wanted to be able to continue serving the more than 6,000 patients currently enrolled.

"These were gut-wrenching decisions," Clymore said. "These are people we know."

New applicants have been placed on a more than 200-person waiting list to meet with case workers who are helping them apply to medication assistance programs. The process can be difficult because patients must apply to each drug company separately and all companies have different processes and applications, Clymore said.

Medications to treat HIV and AIDS can cost thousands of dollars a month, Clymore said. Patients take between three and five HIV medications in combination.

Among the medications needed are antiretrovirals, which most patients need to help them fight HIV infection.

"If you are on antiretroviral medications, you don't want to stop them, certainly not unless a doctor tells you to, because your body can build up resistance and your HIV gets stronger," Clymore said.

In addition to closing the program to new applicants, ADAP has also cut out assistance programs for medications for side effects of HIV and AIDS. The only drug programs available through ADAP are for life-saving drugs. Medicines that treat side effects can be stopped without the same type of effects from stopping an antiretroviral medication, Clymore said.

"It is a bare-bones program right now," she said.

The North Carolina branch is among 11 ADAP programs across the country that has a waiting list of patients.

To qualify for ADAP in North Carolina, a patient must be at or below 300 percent of the federal poverty level and do not have other resources, like Medicaid or private insurance.

"It is really a program for people who have nothing else," Clymore said.

People on the waiting list are at or below 125 percent of the poverty level.

"We are talking about folks that are so unbelievably poor that they have no way to get access to health care, much less medications that are going to keep them alive," Womble said. "If we don't get them the medications, we are killing them."

Clymore said the program has put in an emergency request to Congress asking for $126 million in emergency funds for state programs.

State Sen. Bill Purcell, D-Scotland County, said the congressional delegation is working to get federal money for the program. "There's not any state money," he said.

Purcell commends the program for keeping its patients on the program, despite the cuts.

"As a physician in my other life, it bothers me that people are having trouble getting access to these drugs, but we hope that some of these pharmaceuticals help will make a difference," Purcell said.

Sen. Key Hagan said she is concerned that ADAP offices have been forced to start waiting lists.

"I will be leading the annual appropriations letter asking for increased funding for all HIV/AIDS programs, including a $370 million increase for ADAP," Hagan said Tuesday.

Gov. Bev Perdue is in the process of putting together a budget and ADAP is one of the programs she will examine, a spokeswoman for Perdue's office told WRAL News Tuesday.