Smith S R, Buchanan R J
Division of Pharmaceutical Policy and Evaluative Sciences, School of Pharmacy, Center for AIDS Research, the University of North Carolina at Chapel Hill, USA.
Ann Pharmacother. 2001 Feb;35(2):155-66. doi: 10.1345/aph.10077.
AIDS drug assistance programs (ADAPs) have been implemented in each state to facilitate access to medications for low-income, uninsured, and underinsured people with HIV disease. Policies for each ADAP differ, and these differences influence the access people with HIV have to medications.
To compare the coverage of medications and sources of program funding for the state ADAPs.
A self-administered mailed survey, sent to administrators of the 50 state ADAPs and the District of Columbia ADAP in December 1998.
Forty-nine of the 51 ADAPs (96%) responded to the survey. Title II of the Ryan White Comprehensive AIDS Resources Emergency Act provided a large majority of the funding for the ADAPs, with a number of states also using state funds and/or Title I funds for their programs. The formularies of all ADAPs were nearly identical with respect to coverage of antiretrovirals, but differed in the number and types of other medications included. Some states limited access to medications through waiting lists, enrollment caps, and other policies. Sixteen ADAPs reported that the coverage of protease inhibitors resulted in an appropriation of state government funds to their ADAP, while eight states reported an ADAP budget shortfall. In general, ADAPs in poorer and more rural states included a fewer number of medications on their formularies.
Access to antiretrovirals and other medications is available through state ADAPs, but may be limited in some states due to waiting lists, controls on the enrollment of new beneficiaries, and policies on the number and types of medications beneficiaries may receive.
每个州都实施了艾滋病药物援助计划（ADAPs），以方便低收入、未参保和参保不足的艾滋病毒感染者获得药物。每个ADAP的政策各不相同，这些差异影响着艾滋病毒感染者获得药物的机会。
比较各州ADAP的药物覆盖范围和项目资金来源。
1998年12月向50个州的ADAP管理人员和哥伦比亚特区的ADAP管理人员发送了一份自填式邮寄调查问卷。
51个ADAP中有49个（96%）回复了调查。《瑞安·怀特全面艾滋病资源紧急法案》第二章为ADAP提供了大部分资金，一些州还将州资金和/或第一章资金用于其项目。所有ADAP的处方集在抗逆转录病毒药物的覆盖范围方面几乎相同，但在其他药物的数量和类型上有所不同。一些州通过等候名单、登记上限和其他政策限制了药物获取。16个ADAP报告称，蛋白酶抑制剂的覆盖范围导致州政府向其ADAP拨款，而8个州报告ADAP预算短缺。一般来说，较贫困和农村地区较多的州的ADAP在其处方集中列出的药物数量较少。
通过州ADAP可以获得抗逆转录病毒药物和其他药物，但在一些州可能会受到限制，原因包括等候名单、对新受益人的登记控制以及受益人可获得的药物数量和类型的政策。
