ADAP

The AIDS Drug Assistance Programs (ADAPs) provide HIV-related prescription drugs to low-income individuals with limited or no prescription drug coverage.

With almost 200,000 enrollees nationwide, ADAPs reach over a third of all people with HIV receiving care in the United States.

ADAPs are subject to annual federal appropriations. Congress funds the ADAPs through Part B of the Ryan White Program, which is allocated by formula to states. ADAPs also receive some state funding but this support is highly variable and largely dependent on state and local decisions and resources.

Jurisdictions that receive ADAP funding include all 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, Federated States of Micronesia, Marshall Islands, and the Northern Mariana Islands.

Each state operates its own ADAP, including determining eligibility criteria and other program elements, resulting in significant variation in ADAPs across the country.

All ADAPs participate in the 340B program, enabling them to purchase drugs at or below the statutorily defined 340B ceiling price. Some state ADAPs also purchase drugs directly from wholesalers or through a pharmacy network.

Some ADAPs also use ADAP earmark funding to purchase health insurance and/or pay insurance premiums, co-payments, or deductibles for people with HIV/AIDS.

Background

ADAPs began serving clients in 1987, when Congress first appropriated funds to help states purchase the only approved antiretroviral (ARV) drug available at the time. In 1990, they were incorporated into Part B of the newly enacted Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, now known as the Ryan White Program.

In 2003 the Medicare Modernization Act was implemented, which added the Medicare Part D prescription drug benefit to the program. Because ADAPs fall under the same payer-of-last-resort designation as the rest of the Ryan White Program, ADAPs must ensure that any Medicare Part D-eligible client is enrolled in Part D.