The rapid growth of the HIV epidemic among poor and historically underserved populations, and evolving treatment standards that involve more than one antiretroviral drug, contributed to these strains. In addition, the number of people seeking and receiving treatment for HIV and AIDS continues to increase on a monthly basis. ADAP Funding ADAP funding has increased dramatically in recent years. As the number of FDA-approved HIV treatments has increased, States have added some or all of the newer drugs within the limits of available resources. The availability of new, effective drugs, combined with the greatly increased cost of new medications, has affected the expansion of formularies.
States determine which drugs to include on their formularies.
There is considerable variation in the number of drugs on ADAP formularies, ranging from 15 to more than 400, with approximately 75 percent of the States covering 30 or more drugs. Many ADAPs were established to operate under a pharmacy reimbursement model similar to Medicaid. This allows patients to go to a participating pharmacy, show their ADAP cards, and have their prescriptions filled. Alternatively, States with a system of pharmacies attached to a network of public health clinics use that system to purchase and distribute drugs for ADAP clients. A few ADAPs directly purchase drugs and mail them to clients.