Access to Hepatitis C Treatment Through State AIDS Drug Assistance Programs (ADAPs)

By Tracy Swan

May 31, 2007

The Henry J. Kaiser Family Foundation and the National Association of State and Territorial AIDS Directors (NASTAD) released the 2007 National ADAP Monitoring Project Annual Report on April 10th, 2007.

Access to hepatitis C treatment is crucial for HIV/HCV coinfected people. Although hepatitis C can be treated, HCV-associated end-stage liver disease has become a leading cause of death among HIV-positive people in the US.

Although funding shortfalls and increasing need mean that the majority of ADAPs are currently unable to provide pegylated interferon and ribavirin, some are still covering HCV treatment and/or adjunctive therapies used to manage side effects (see table of State ADAP Coverage below). Some State ADAPs offer hepatitis A (HAV) and hepatitis B (HBV) vaccines, which are recommended for people with HIV and hepatitis C who are susceptible to these viruses.

If your State ADAP does not cover hepatitis C treatment, you may be able to obtain it through patient assistance programs sponsored by Roche and Schering.

Roche Patient Assistance Foundation: 1-877-75ROCHE (877-757-6243)
Schering Commitment to Care (1-800-521-7157)
Direct link to Schering’s Commitment to Care Application (accessed May 21 2007): www.schering-plough.com/pdf/commitapp.pdf

State ADAP Coverage: Hepatitis A (HAV) & Hepatitis B (HBV) Vaccines, Hepatitis C Treatment, Growth Factors, & Selective Serotonin Reuptake Inhibitors (SSRIs) as of May 2007
State	IFN (PEG, Standard, Consensus)	RBV	SSRIs/ Other*	Epoetin- Alfa	Filgrastim	HAV & HBV Vaccine	Waiting List/ Other Cost Containment
ALABAMA				X			Capped enrollment
ALASKA						X
ARIZONA	PEG-IFN	X	X	X	X	X
ARKANSAS
CALIFORNIA	Standard IFN	X	X	X	X	X
COLORADO
CONNECTICUT	PEG-IFN	X	X		X	X
DELAWARE	PEG-IFN	X	X	X	X
DISTRICT OF COLUMBIA	Standard IFN	X	X	X
FLORIDA				X	X	X	Lowered income eligibility
GEORGIA				X
HAWAII			X	X	X
IDAHO							Cost containment anticipated before 3/31/08
ILLINOIS	Standard IFN
INDIANA			X				Capped enrollment
IOWA
KANSAS
KENTUCKY						X	Cost containment anticipated before 3/31/08
LOUISIANA
MAINE
MARYLAND	PEG-IFN, Standard IFN	X	X		X
MASSACHUSETTS	All FDA-approved drugs are covered**
MICHIGAN	PEG-IFN, Standard IFN	X	X	X	X	X	Formulary management
MINNESOTA			X
MISSISSIPPI	PEG-IFN	X	X				Lowered medical eligibility
MISSOURI			X			X
MONTANA			X	X	X		Waiting list
NEBRASKA			X	X	X
NEVADA			X	X
NEW HAMPSHIRE		X	X	X			Cost containment anticipated before 3/31/08
NEW JERSEY	All FDA-approved drugs are covered**
NEW MEXICO			X	X		X
NEW YORK	PEG-IFN	X	X	X	X	X
NORTH CAROLINA			X
NORTH DAKOTA			X			X
OHIO			X		X
OKLAHOMA
OREGON				X	X
PENNSYLVANIA	PEG-IFN	X		X	X	X
PUERTO RICO	PEG-IFN, Standard IFN	X	X	X	X		Waiting List
RHODE ISLAND	PEG-IFN, Standard IFN	X	X				Lowered income eligibility; additional cost containment anticipated by 3/31/08
SOUTH CAROLINA			X			X	Waiting List; reduced formulary; capped enrollment
SOUTH DAKOTA			X			X
TENNESSEE	PEG-IFN	X	X		X
TEXAS
U.S. VIRGIN ISLANDS							Client cost sharing; additional cost containment anticipated by 3/31/08
UTAH
VERMONT			X		X	X
VIRGINIA	PEG-IFN	X		X		X
WASHINGTON	PEG-IFN, Standard IFN	X	X	X		X
WEST VIRGINIA
WISCONSIN	PEG-IFN	X	X (Elavil only)			X
WYOMING		X				X

* May include anti-anxiety agents, anti-depressants, anti-psychotics, mood stabilizers, and other psychiatric medications.

**With certain exclusions.

Sources:

Henry J. Kaiser Family Foundation, National Alliance of State and Territorial AIDS Directors (NASTAD). National ADAP Monitoring Project, Annual Report, April 2007. ADAP Formularies. Available on-line at: www.kff.org/hivaids/7619.cfm (accessed on May 9th, 2007).
NASTAD. ADAP Watch. April 2007. Available on-line at: www.nastad.org/Publications/adapwatch.aspx (accessed on May 9th, 2007).

Thanks to Britten Ginsburg, Murray Penner, Beth Crutsinger-Perry and Chris Taylor at NASTAD.

Tracy Swan is TAG’s Coinfection Project Director.