NATIONAL ADAP MONITORING PROJECT - NASTAD · May 2015. 4 The AIDS Drug Assistance Program (ADAP)...

NATIONALADAPMONITORINGPROJECT 2015 ANNUAL REPORT

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The National Alliance of State & Territorial AIDS Directors (NASTAD) thanks state ADAP and AIDS program managers and staff for their time and effort in completing the National ADAP Monitoring Survey, which serves as the foundation for this report, and for providing ongoing updates to inform the National ADAP Monitoring Project. NASTAD also thanks Lanny Cross, NASTAD consultant, for his valuable contributions to NASTAD’s ADAP Monitoring and Technical Assistance Program. Finally, without the guidance and support from Murray Penner, NASTAD Executive Director, this report would not be possible.

The National ADAP Monitoring Project is one component of NASTAD’s National ADAP Monitoring and Technical Assistance Program which provides ongoing technical assistance to all state and territorial ADAPs. The program also serves as a resource center, providing timely information on the status of ADAPs, particularly those experiencing resource constraints or other challenges, to national coalitions and organizations, policy makers, industry members, and state and federal government agencies. NASTAD received support for the National ADAP Monitoring and Technical Assistance Program in 2014 from the following companies: AbbVie, Bristol-Myers Squibb, Gilead Sciences, Janssen Therapeutics and ViiV Healthcare. NASTAD also receives funding to provide technical assistance to ADAPs through a Training and Technical Assistance Cooperative Agreement with the Health Resources and Services Administration (HRSA).

Amanda Bowes, Ann Lefert, and Britten Pund are the contributing authors and editors of this document.

ACKNOWLEDGEMENTS

Murray C. Penner, Executive Director Maria Courogen, Washington, Chair

May 2015

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The AIDS Drug Assistance Program (ADAP) was introduced as a line item in the then Title II (now Part B) of the federal Ryan White Program appropriation in 1996. This represented the first time that low-income, under and uninsured individuals had relatively unrestricted access to HIV antiretroviral (ARV) medications. In 2000, the program was expanded to allow for the purchase of insurance for individuals who could otherwise not afford coverage. While several states chose to purchase insurance for clients, it was not until the implementation of the Affordable Care Act (ACA) in 2013 that ADAPs significantly shifted services to include purchasing or continuing insurance for its clients.

Today, ADAPs provide life-saving HIV treatments to low income, uninsured, and underinsured individuals living with HIV/AIDS in all 50 states, the District of Columbia, the Commonwealth of Puerto Rico, the U.S. Virgin Islands, American Samoa, the Federated States of Micronesia, Guam, the Northern Mariana Islands, Republic of Palau and the Republic of the Marshall Islands. Most ADAPs also provide private insurance continuation and Medicare Part D and Medicaid wrap-around services to eligible individuals.

The structure of ADAP has changed in the past two decades, taking the form of a two-pronged program to provide: 1) the full purchase of medications and/or 2) the purchase of insurance coverage or payment of co-payments/coinsurance or deductibles — on behalf of eligible individuals. And ADAP continues to evolve in order to interact with the changing health system and to meet the needs of people living with HIV (PLWH). Through this transition, it is important to understand the basics of ADAP.

THE REFORMATION OF ADAP: INTEGRATION INTO A CHANGING HEALTH SYSTEM

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MONITORINGPROJECT

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The Funding to Provide Services The total ADAP budget remained constant between FY2013 and FY2014 at $2.01

billion. • In FY2014, the ADAP earmark was $782 million. The earmark was one-

quarter of the total ADAP budget in FY1996, the year it was created, rose to more than two-thirds (68%) of the budget in FY2000 and has most recently declined as a share of the overall budget to 35% in FY2014. The ADAP earmark itself decreased by 1% from FY2013, when ADAPs experienced a 5% decrease to all federal funding sources.

• Drug rebates accounted for $960.3 million, or 43%, of the overall ADAP budget in FY2014. This funding represents money that is paid to the state by manufacturers as a result of active filing of rebate claims based on drug purchases.

• State contributions accounted for $233.2 million, or 11%, of the overall ADAP budget in FY2014.

The Individuals Seeking Service from ADAP • Race/Ethnicity:

Thirty-five percent of clients served by ADAP in June 2014 were Non-Hispanic Black/African American while 31% and 28% were Non-Hispanic White and Hispanic, respectively.

• Gender: The majority (71%) of clients served by ADAP in June 2014 were male.

Twenty-seven percent were female, 0.4% were transgender and 2% were reported as gender unknown.

• Age: The overwhelming majority (90%) of clients served by ADAP in June 2014 were between the ages of 25 and 64 years; 40% were aged 25 – 44 years while 50% were aged 45 – 64 years.

• Income Level: The majority (56%) of clients served by ADAP in June 2014 had incomes

below 138% of the Federal Poverty Line (FPL).1 In 2014, the ACA expanded Medicaid eligibility to most people with income up to 133% of the federal poverty level (FPL). However, in addition to new income accounting rules for most Medicaid populations (called “Modified Adjusted Gross Income”), there is an additional 5% disregard of income in calculating eligibility, effectively bumping the Medicaid income eligibility threshold to 138% FPL.

1 The 2014 Federal Poverty Level (FPL) was $11,670 (slightly higher in Alaska and Hawaii) for a household of one.

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The Service Being Provided The distribution of drug expenditures and prescriptions provided within ADAPs

varies across the country, reflecting differing formularies and prescribing patterns. ARVs, the standard of care for HIV, account for the majority of ADAP drug expenditures and prescriptions filled. ADAP drug expenditures were $159,108,884 in June 2014, ranging from a low

of $51,881 in North Dakota, to a high of $28.5 million in California (see Table 20).

In June 2014, the average expenditures per prescription were significantly higher for ARVs ($401) than non-ARVs ($69 for “A1” OIs and $42 for all other drugs).

ADAPs purchase or continue insurance and pay for premiums, co-payments and deductibles on behalf of ADAP clients, closely interacting with existing other payer sources. ADAP payment of client co-payments was 20% of overall drug purchases (see Table 22).

Twenty-four states reported 40% or more of total ADAP drug expenditures spent on co-payments in June 2014.

The information contained in this Report outlines how ADAP has evolved as a result of its growth and health care system changes.

FACT 1: Since the advent of ADAP being able to purchase insurance, the overall structure of the program has not changed. The structure of the program, a two-pronged approach to purchasing medications at full cost or purchasing insurance, has not shifted dramatically since 2003. The proportion of clients served by each

Composition of ADAP Clients Served, June 2002 and June 2014

5,272(7%)

74,763(93%)

85,416(58%) Uninsured

Individuals

Insured Individuals

June 2002 June 2014

61,456(42%)

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approach has changed dramatically. As ADAPs have honed their program structures and worked to meet the infrastructure needs of supporting a two-pronged program, they have gained the ability to serve more clients. The number of uninsured clients served by ADAP increased by 84% between 2002 and 2014. By comparison, the number of insured clients served by ADAP increased by 1066% between 2002 and 2014.

FACT 2: Health reform has been implemented differently in states, creating new disparities and illuminating further stressors on the public health system in the US. This has acutely impacted ADAP – causing a divide among states and regions and their ability to provide comprehensive services to clients. Medicaid expansion under the ACA extends Medicaid eligibility to 138% FPL regardless of disability, family status, financial resources and other individual factors that impact eligibility decisions in non-expansion states. The ACA requires newly eligible Medicaid beneficiaries (those ineligible under past Medicaid law, but who

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Current Status of State Medicaid Expansion Decisions

State Health Insurance Marketplace Types, 2015

Adopted (29 States including DC)

Federally- facilitated Marketplace

Adoption under discussion (6 States)

State-Partnership Marketplace

Not Adopting at this time (16 States)

State-based Marketplace

Federally-supported State-based Marketplace

Source: Kaiser Family Foundation

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are eligible post-expansion) to have access to a benchmark benefits package that includes ten categories of essential health benefits; this benchmark is not available in non-expansion states. The ACA also established Marketplaces to create a convenient electronic platform for eligible individuals to shop for health insurance coverage. In addition to enrolling eligible individuals into health insurance coverage, Marketplaces screen for Medicaid eligibility and administer premium tax credits and cost-sharing reductions for Qualified Health Plans, as applicable.

Based on ADAPs assessments of which plans to purchase for their clients, the majority of HIV ARVs were reported as being covered by at least one private insurance plan within each state. However, nine HIV ARVs were reported as not being covered by at least one private insurance plan available in a state, in or out of the ACA marketplace, including: amprenavir, APV (Agenerase) (n = 7, 15%); tenofovir, disproxil fumarate, TDF (Viread) (n = 2, 4%); and tenofovir disoproxil fumarate and emtricitabine (Truvada) (n = 2, 4%). The HIV ARVs reported by an ADAP as not being covered by at least one private insurance plan were: abacavir, zidovudine, lamivudine (Trizivir); cobicistat, elvitegravir, emtricitabine, tenofovir disoproxil fumarate (Stribild); efavirenz, emtricitabine, tenofovir disproxil fumarate (Atripla); emtricitabine, rilpivirine, tenofovir disoproxil fumarate (Complera); stavudine, d4T (Zerit); and zidovudine, azidothymidine, AZT, ZDV.

FACT 3: ADAPs provide a safety-net that bends and stretches to ensure that PLWH receive access to medications. ADAPs are a leader within the Ryan White Program on linkage to and retention in care, demonstrating improved health outcomes.

ADAPs play a critical role in efforts to end the HIV epidemic nationally by having a measurable impact on multiple “bars” within the HIV prevention to care continuum, most notably linkage to and retention in care and treatment. ADAPs’ support of insurance and direct provision of ARV therapy and other medications to PLWH is necessary in order for clients to achieve optimal health outcomes including viral load suppression. Viral load suppression in turn greatly reduces HIV transmission and rates for new infections. In addition to viral load suppression, improved access to care and treatment is associated with elevations in CD4 count and reductions in PLWH’s progression to CDC-defined AIDS.2

• The majority (63%) of all clients served by ADAPs in June 2014 were reported as virally suppressed, defined as having a viral load that is less than or equal to 200 copies/mL. Eleven percent of clients served in June 2014 were reported as having had a viral load recorded as greater than 200 cells/mL while 26% were reported as having an unknown viral load (see Table 14). Rates for viral load suppression were calculated based on the most recent viral load recorded for each client as of

2 The AIDS case definition used as part of this Survey may be found here and is consistent with the most recent ADAP Data Report (ADR) submission. The ADR is the reporting system through which ADAP grantees must submit quarterly reports to HRSA as part of the funding requirements. More information on the ADR may be found here. CDC released an updated case definition in April 2014 (located here).

http://hab.hrsa.gov/deliverhivaidscare/coremeasures.pdf

http://www.cdc.gov/mmwr/preview/mmwrhtml/00018871.htm

http://hab.hrsa.gov/manageyourgrant/adr.html

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6303a1.htm?s_cid=rr6303a1_e

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June 30, 2014 among those served by the ADAP program in June 2014 (including those clients not on ARV medications). If a client did not receive a viral load during June 2014, ADAPs reported based on the last viral load recorded for that individual prior to June 30, 2014.

• Forty-two percent of all clients served by ADAPs in June 2014 had a CD4 count recorded as greater than 500 cells/mm3. Thirty-six percent of clients served had a CD4 count less than or equal 500 cells/mm3 while 22% were reported as having an unknown CD4 count (see Table 13). CD4 count data were calculated based on the most recent CD4 count recorded for each client as of June 30, 2014 among those served by the ADAP program in June 2014 (including those clients not on antiretroviral medications). If a client did not receive a CD4 count during June 2014, ADAPs reported based on the last CD4 count recorded for that individual prior to June 30, 2014.

• Clients served by ADAPs during June 2014 were reported as having the following HIV statuses: Thirty-four percent were “HIV-positive, not AIDS” Twenty-eight percent were “HIV-positive, AIDS status unknown” Twenty-six percent were “CDC-defined AIDS” Twelve percent were “Unknown”

258,469(100%) 238,253

(92%) 211,945(82%)

175,759(68%)

ADAP clientenrollment

ADAP clientutilization

ADAP clientretention

ADAP clienthealth outcome

ADAP client enrollment – the number of clients enrolled in ADAP in FY2013

ADAP client utilization – the number of clients served by ADAP (receiving medications) in FY2013

ADAP client retention – the number of clients who were successfully recertified by ADAP twice in a 12-month period of time

ADAP client health outcome – the number of ADAP clients who reported an increased CD4 count over a 12-month period of time

Engagement in ADAP

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FACT 4: ADAP clients are obtaining new forms of coverage. People are moving to Medicaid and are thriving; ADAP is no longer necessary for the majority of those individuals. People are moving to private insurance options; ADAP is remaining the primary payer. People are, in some instances for the first time, able to access insurance and comprehensive health services beyond those covered through the Ryan White Program. ADAPs have spent considerable time over the past year assisting its clients in transitioning to new forms of coverage; as a direct result, ADAP enrollment is shifting.

• ADAPs served over 146,000 clients in June 2014, representing a 4% decrease overall from June 2013. Sixteen (16) ADAPs reported increases of 5% or more clients served while twenty-one (21) reported decreases of 5% or more in the number of clients served. For the purposes of this Report, ADAP clients are considered to be enrolled in either the full-pay medication program or the insurance program. Full-pay medication program clients are defined as those individuals who receive medications paid in full by ADAP with no coordination of insurance or benefits. Insurance program clients are defined as those who have some type of coverage other than ADAP (i.e., private insurance, Medicaid, Medicare) and ADAP pays the premiums, deductibles and/or co-payments/co-insurance on behalf of clients. Over 85,000 clients (58%) were served by an ADAP’s full-pay medications

program only. Over 58,000 clients (40%) were served by an ADAP-funded insurance program

only.3

Over 3,000 clients (2%) were served by ADAP’s full-pay medications and insurance programs.4

• During ADAP FY2013 (April 1, 2013 – March 31, 2014), 258,469 clients were enrolled nationwide in ADAPs. Client enrollment ranged from 129 individuals in Alaska to 41,192 in California in FY2013. Fewer clients are typically served in ADAPs than are enrolled at any given time—ADAPs served 238,253 clients in FY2013 (see Table 5). Over 144,000 clients (60%) were served by an ADAP’s full-pay medications

program only. Over 78,000 clients (33%) were served by an ADAP-funded insurance program

only.5

Over 15,000 clients (7%) were served by ADAP’s full-pay medications and insurance programs.6

3 Individuals who had an insurance (i.e., Medicare Part D, Medicaid, private insurance) payment (premium, co-payment/co-insurance, and/or deductible) paid on their behalf using ADAP funds, either fully or in part.

4 This includes clients who enrolled in an insurance plan mid-year and those who were enrolled in an insurance plan that did not cover one or more medically necessary medications such that the ADAP’s full-pay prescription program did instead.



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• Seventeen ADAPs (36%) reported that they provide services to individuals incarcerated in county or city jails.7 Of these, six reported having used federal funds to support this provision and one reported having used state funds. Ten ADAPs used a combination of federal and state funds.

FACT 5: People living with HIV enrolled in ADAP cannot afford insurance. ADAP remains the primary payer for those individuals.

The Ryan White Program allows states to use ADAP dollars to purchase health insurance and pay insurance premiums, co-payments and/or deductibles for individuals eligible for ADAP, provided the insurance has comparable formulary benefits to that of the ADAP. States are increasingly using ADAP funds for this purpose.

• Twenty-eight (58%) ADAPs reported that they pay premiums on behalf of clients. Twenty-eight (58%) ADAPs reported that they pay deductibles while 32 (67%) pay co-payments/co-insurance costs (prescriptions only) and 9 (19%) pay co-payments/co-insurance costs (medical only).8

• Forty-five ADAPs reported using funds for insurance purchasing/continuation in 2014 representing $421 million in estimated expenditures in FY2014. ADAPs reported spending over $110.7 million on insurance purchasing/continuation in June 2014 (see Table 26). By comparison, forty-four ADAPs used funds for insurance purchasing/continuation in 2013, totaling $397 million in FY2013 and $27.6 million in June 2013.

7 In September 2007, the HIV/AIDS Bureau (HAB) updated their policy describing the use of Ryan White HIV/AIDS Program funds for transitional social support and primary care services for incarcerated persons. The policy supports the use of Ryan White HIV/AIDS Program funds for incarcerated persons as they prepare to exit the correctional system as part of effective discharge planning or when they are in the correctional system for a brief period, which would not include any discharge planning. More information on the policy may be found here.

8 Federal ADAP funds cannot be used to pay for medical co-payments/co-insurance.

ADAP Clients by Type of Coverage, June 2014

85,416(58%)

431,694(80%)

$1,672(90%)

Uninsured/ full-pay

Insured/ partial pay

ADAP clients served ADAP prescriptions filled

Average cost per client

61,456(42%)

105,807(20%)

$182 (10%)

http://hab.hrsa.gov/manageyourgrant/pinspals/incarceratedpersons0704.html

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• In June 2014, 61,456 ADAP clients were covered by such arrangements (see Chart 21 and Table 25). Clients served through insurance coordination increased 17% from June 2013 (52,568 clients served). Among clients who received insurance purchasing/continuation services: 8,264

(13%) had premiums payments only made on their behalf; 26,886 (44%) had deductible/co-payment/co-insurance payments only made on their behalf; and 25,515 (42%) had premiums and deductible/co-payment/co-insurance payments made on their behalf.

• In June 2014, the average cost per client was $1,672 for drug purchases/co-payments and $182 for insurance purchasing and continuation.

The landscape of public health and the overall health system has changed over time, presenting new opportunities for access to care for vulnerable populations but also illuminating existing and continued gaps to access care. ADAPs have navigated the processes of change and growth to remain relevant by expanding and updating its structure, assisting clients in accessing new forms of medications and medical coverage, and maintaining and providing vital and enabling services that bolster those available through the Ryan White Program.

ADAP Clients Served, by Other Payers, June 2014

Medicaid

Medicare Part D Standard Benefit

Medicare Part D Full Subsidy 19

No Form of Insurance

Medicaid and Medicare

Private Insurance Coverage

Medicare Part D Partial Subsidy

Unknown

50%

24%

8%

4%8% 2%

2%1%

9 Asset limits for full- vs. partial-subsidy under Medicare Part D may be found here.

http://www.medicarerights.org/fliers/Help-With-Drug-Costs/Extra-Help-Chart.pdf?nrd=1

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Since 1996, NASTAD’s National ADAP Monitoring Project has surveyed all jurisdictions receiving federal ADAP earmark funding through the Ryan White Program. In FY2014, 59 jurisdictions received earmark funding and were surveyed; 48 responded. American Samoa, Delaware, Federated States of Micronesia, Kentucky, Marshall Islands, Mississippi, Northern Mariana Islands, Republic of Palau, Rhode Island, Vermont, and Virgin Islands (U.S.) did not respond. This 20th release of the Annual Report updates prior findings with data from ADAP’s fiscal year 2014 as well as a detailed snapshot of data from the month of June 2014. The Annual Report reflects the latest available data and discusses recent policy and programmatic changes affecting ADAPs.

The annual survey requests data and other program information for a one-month period (June), the current fiscal year, and other periods as specified. After the survey is distributed, NASTAD conducts extensive follow-up to ensure completion by as many ADAPs as possible. Data used in this report are from June 2014 and FY2014, unless otherwise noted.

All data reflect the status of ADAPs as reported by survey respondents. It is important to note that some program information may have changed between data collection and the Annual Report’s release. Due to differences in data collection and availability across ADAPs, some are not able to respond to all survey questions. Where trend data are presented, only states that provided data in relevant periods are included. In some cases, ADAPs have provided revised program data from prior years and these revised data are incorporated where possible. Therefore, data from prior year reports may not be comparable for assessing trends. It is also important to note that data from a one-month snapshot may be subject to one-time only events or changes that could in turn appear to impact trends; these are noted where information is available. Data exceptions specific to a particular jurisdiction are provided in the notes section on relevant charts and tables.

METHODOLOGY

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CHARTS AND TABLES

Charts for each major finding, tables, with data provided by state, and a complete ADAP glossary are included in the

full report. State-level data from this report are available on the NASTAD website.

Charts

Chart 1: Total ADAP Budget, FY1996-FY2014 21

Chart 2: Total ADAP Budget, by Source, FY1996-FY2014 21

Chart 3: Total ADAP Budget, by Source, FY2014 22

Chart 4: Part B ADAP Earmark, FY1996-FY2014 22

Chart 5: Part B ADAP Supplemental Funding, FY2001-FY2014 22

Chart 6: Part B Base Contribution Directed to ADAP, FY1996-FY2014 23

Chart 7: Part A Contribution Directed to ADAP, FY1996-FY2014 23

Chart 8: State Contribution, FY1996-FY2014 23

Chart 9: Estimated Drug Rebates, FY1996-FY2014 24

Chart 10: ADAP Client Enrollment, June 2003-2014 24

Chart 11: ADAP Client Utilization, June 1996-2014 24

Chart 12: ADAP Clients Served and Top Ten States, by Clients Served, June 2014 25

Chart 13: ADAP Clients Served, by Other Payers, June 2014 25

Chart 14: ADAP Clients Served, by Race/Ethnicity, June 2014 26

Chart 15: ADAP Clients Served, by Gender, June 2014 26

Chart 16: ADAP Clients Served, by Age, June 2014 27

Chart 17: ADAP Clients Served, by Income Level, June 2014 27

Chart 18: ADAP Drug Expenditures and Top 10 States, by Drug Expenditures, June 2014 28

Chart 19: ADAP Drug Expenditures and Prescriptions Filled (Including Drug

Purchases and Co-Payments), June 2014 28

Chart 20: ADAP Drug Expenditures and Prescriptions Filled (Including Drug Purchases

and Co-Payments), by Drug Category, June 2014 28

Chart 21: Clients Served and Estimated Expenditures in Insurance Purchasing and

Continuation, 2014 29

Chart 22: ADAP Premium Assistance, by Income Level, FY2014 29

Chart 23: ADAP Deductible Assistance, by Income Level, FY2014 30

https://www.nastad.org/resources.aspx?category=National%20ADAP%20Monitoring%20Project%20Annual%20Report

Chart 24: ADAP Co-Payments/Co-Insurance (prescription only) Assistance, by

Income Level, FY2014 30

Chart 25: ADAP Co-Payments/Co-Insurance (medical only) Assistance, by

Income Level, FY2014 31

Chart 26: ADAP Requires Client Takes Advance Tax Credit, by Income

Level, FY2014 31

Chart 27: ADAP Requires Client Tax Return Submission, by Income

Level, FY2014 32

Chart 28: ADAP Medicare Part D Premium Assistance, by Income

Medicare Benefit Level, FY2014 32

Chart 29: ADAP Medicare Part D Deductible Assistance, by Income

Medicare Benefit Level, FY2014 33

Chart 30: ADAP Co-Payments Assistance, by Medicare Benefit Level, FY2014 33

Chart 31: ADAP Medicare Part D Donut Hole Assistance, FY2014 34

Chart 32: ADAP Eligibility, by Medicare Benefit Level, FY2014 34

Chart 33: ADAP Provision of Services for Incarcerated Individuals, FY2014 35

Tables

Table 1: Total Budget, FY2013 and FY2014 37

Table 2: Total ADAP Budget, by State and by Source, FY2014 38

Table 3: Major FY2014 Budget Categories Compared with FY2013 40

Table 4: Cost Recovery and Other Cost-Saving Mechanisms (Excluding

Drug Rebates), FY2013 42

Table 5: Total Clients Enrolled/Served and Program Expenditures, FY2013 44

Table 6: Total Clients Enrolled and Served, June 2013 and June 2014 46

Table 7: ADAP Clients Served by Other Payers, June 2014 47

Table 8: ADAP Clients Served, by Race/Ethnicity, June 2014 48

Table 9: ADAP Clients Served, by Gender, June 2014 49

Table 10: ADAP Clients Served, by Age, June 2014 50

Table 11: ADAP Clients Served, by Income Level, June 2014 51

Table 12: ADAP Clients Served, by HIV/AIDS Status, June 2014 52

Table 13: ADAP Clients by CD4 Count, Enrolled During 12-Month Period, June 2014 54

Table 14: ADAP Clients by Viral Load, Enrolled During 12-Month Period, June 2014 56

Table 15: ADAP Client Enrollment Processes, as of June 30, 2014 57

Table 16: ADAP Client Financial Eligibility Requirements, as of June 30, 2014 58

Table 17: ADAP Client Medical Eligibility Requirements, as of June 30, 2014 59

Table 18: ADAP Client Eligibility Requirements, as of June 30, 2014 60

Table 19: ADAP Drug Purchasing, June 2014 61

Table 20: ADAP Drug Expenditures (Including Purchases and Co-payments),

June 2014 62

Table 21: ADAP Drug Expenditures (Including Purchases and Co-payments),

by Drug Category, June 2014 63

Table 22: ADAP Prescriptions Filled (Including Purchases and Co-payments),

June 2014 64

Table 23: ADAP Prescriptions Filled (Including Purchases and Co-payments),

by Drug Category, June 2014 65

Table 24: ADAP Prescription Distribution, June 2014 66

Table 25: Clients Served Through Insurance Purchasing and Continuation, 2014 68

Table 26: ADAP Funds Used and Clients Served Through Insurance

Purchasing and Continuation, 2014 69

Table 27: ADAP Policies Related to Insurance Purchasing as of June 30, 2014 70

Table 28: ADAP Policies Related to Medicare Part D, as of June 30, 2014 72

Table 29: ADAP Management Practices in Place, as of June 30, 2014 74

Table 30: Key Dates in the History of ADAP 76

Table 31: HIV/AIDS Antiretroviral and Opportunistic Infection Medications 77

Glossary

A glossary of key ADAP terms can be found on the NASTAD website.

http://bit.ly/1by7nrV

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CHARTS

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TABLES

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State/Territory Total FY2014 Budget Part B ADAP Earmark% of Total

Budget

Part B ADAP Supplemental 1

% of Total

Budget

Part B Base Contribution

Directed to ADAP

% of Total

Budget

Part B Supplemental

Directed to ADAP

% of Total Budget

Alabama $19,776,510 $10,035,042 51% $796,339 4% $0 0% $0 0%Alaska $2,390,836 $544,108 23% $51,071 2% $0 0% $8,871 0.4%American Samoa $1,651 $1,651 100% $0 0% -- -- -- --Arizona $28,162,067 $10,822,719 38% $0 0% $0 0% $0 0%Arkansas $5,433,335 $4,024,255 74% $331,264 6% $0 0% $0 0%California $453,575,244 $97,901,516 22% $9,189,227 2% $1,500,000 0.3% $0 0%Colorado $18,440,295 $9,727,071 53% $0 0% $0 0% $0 0%Connecticut $27,260,304 $9,109,479 33% $0 0% $0 0% $33,713 0.1%Delaware $4,180,084 $2,680,084 64% $0 0% $0 0% $0 0%District of Columbia $9,449,635 $9,449,635 100% $0 0% $0 0% $0 0%Federated States of Micronesia $0 $0 0% $0 0% -- -- -- --Florida $131,374,926 $85,493,534 65% $6,681,392 5% $2,700,000 2% $0 0%Georgia $51,358,755 $31,015,825 60% $2,911,205 6% $0 0% $0 0%Guam $69,355 $69,355 100% $0 0% -- -- -- --Hawaii $4,114,682 $1,974,147 48% $0 0% $0 0% $0 0%Idaho $5,371,592 $721,625 13% $67,733 1% $0 0% $0 0%Illinois $53,939,883 $28,972,323 54% $2,719,398 5% $0 0% $0 0%Indiana $45,773,323 $7,777,694 17% $730,029 2% $2,070,600 5% $0 0%Iowa $4,830,439 $1,697,552 35% $132,044 3% $0 0% $28,913 0.6%Kansas $22,835,557 $2,522,384 11% $0 0% $0 0% $0 0%Kentucky $4,830,922 $4,830,922 100% $0 0% -- -- -- --Louisiana $37,362,491 $16,057,388 43% $1,282,605 3% $1,832,193 5% $1,459,800 4%Maine $2,424,065 $1,017,210 42% $0 0% $156,855 6% $0 0%Marshall Islands $826 $826 100% $0 0% -- -- -- --Maryland $68,017,127 $25,072,742 37% $0 0% $0 0% $0 0%Massachusetts $24,070,089 $14,426,714 60% $0 0% $0 0% $0 0%Michigan $41,409,633 $12,409,633 30% $0 0% $0 0% $0 0%Minnesota $10,064,066 $5,979,412 59% $0 0% $20,383 0.2% $64,271 1%Mississippi $7,603,480 $7,603,480 100% $0 0% -- -- -- --Missouri $39,083,769 $9,872,387 25% $0 0% $0 0% $0 0%Montana $1,375,518 $362,464 26% $27,917 2% $114,500 8% $0 0%Nebraska $3,470,631 $1,545,631 45% $125,000 4% $0 0% $0 0%Nevada $11,564,891 $6,118,122 53% $0 0% $1,713,241 15% $0 0%New Hampshire $4,165,194 $965,194 23% $0 0% $0 0% $0 0%New Jersey $93,647,360 $30,442,819 33% $2,449,129 3% $0 0% $997,282 1%New Mexico $2,303,598 $2,299,456 100% $0 0% $0 0% $0 0%New York $375,444,243 $111,252,394 30% $0 0% $1,055,757 0.3% $12,179,085 3%North Carolina $57,459,630 $22,137,530 39% $2,077,872 4% $0 0% $1,747,084 3%North Dakota $1,437,458 $174,214 12% $13,856 1% $49,388 3% $0 0%Northern Mariana Islands $9,082 $9,082 100% $0 0% -- -- -- --Ohio $28,529,871 $15,879,871 56% $0 0% $0 0% $0 0%Oklahoma $16,013,111 $4,401,580 27% $0 0% $825,531 5% $0 0%Oregon $36,315,598 $4,645,149 13% $0 0% $0 0% $0 0%Pennsylvania $95,045,318 $28,128,501 30% $0 0% $416,817 0.4% $0 0%Puerto Rico $23,754,044 $15,924,457 67% $1,304,273 5% $71,074 0.3% $1,923,247 8%Republic of Palau $653 $653 100% $0 0% -- -- -- --Rhode Island $1,918,436 $1,776,815 93% $141,621 7% -- -- -- --South Carolina $33,567,631 $12,876,129 38% $1,032,646 3% $0 0% $0 0%South Dakota $1,598,316 $396,316 25% $0 0% $22,000 1% $0 0%Tennessee $48,837,811 $14,034,527 29% $1,317,307 3% $5,283,858 11% $1,268,395 3%Texas $120,889,316 $59,979,065 50% $5,629,751 5% $0 0% $0 0%Utah $6,360,342 $2,104,601 33% $167,772 3% $779,556 12% $37,904 0.6%Vermont $370,720 $370,720 100% $0 0% -- -- -- --Virgin Islands (U.S.) $537,207 $497,046 93% $40,161 7% -- -- -- --Virginia $49,697,868 $17,906,035 36% $1,680,695 3% $2,969,329 6% $323,524 1%Washington $38,935,074 $9,721,292 25% $0 0% $0 0% $0 0%West Virginia $6,600,315 $1,400,315 21% $0 0% $0 0% $0 0%Wisconsin $27,812,566 $4,579,097 16% $429,803 2% $425,000 2% $0 0%Wyoming $1,464,830 $236,138 16% $22,165 2% $275,484 19% $0 0%Total $2,212,331,573 $781,975,926 35% $41,352,275 2% $22,281,566 1% $20,072,089 1%

Table 2: Total ADAP Budget, by State and by Source, FY2014

Note: 48 ADAPs reported data. American Samoa, Federated States of Micronesia, Kentucky, Marshall Islands, Mississippi, Northern Mariana Islands, Republic of Palau, Rhode Island and Vermont did not respond. The total FY2014 budget includes federal, state, and drug rebates. A dash (--) indicates the ADAP did not report data.

1 Part B ADAP supplemental awards were provided to 27 states that met federal eligibility criteria, applied for funding, and were able to meet the mandated matching requirement or receive a waiver.

38

ADAP Emergency Funding

% of Total Budget

Part A Contribution Directed to ADAP

% of Total Budget State Contribution

% of Total

Budget

Estimated Drug Rebates

% of Total

Budget

Other State or Federal

% of Total

Budget

Total FY2014 Budget

$3,638,484 18% $0 0% $4,306,645 22% $1,000,000 5% $0 0% $19,776,510$686,786 29% $0 0% $0 0% $0 0% $1,100,000 46% $2,390,836

$0 0% -- -- -- -- -- -- -- -- $1,651$792,146 3% $0 0% $1,000,000 4% $15,547,202 55% $0 0% $28,162,067

$0 0% $0 0% $82,816 2% $995,000 18% $0 0% $5,433,335$11,000,000 2% $0 0% $53,644,944 12% $278,601,026 61% $1,738,531 0.4% $453,575,244

$0 0% $0 0% $4,513,224 24% $4,200,000 23% $0 0% $18,440,295$0 0% $0 0% $0 0% $18,117,112 66% $0 0% $27,260,304$0 0% $0 0% $0 0% $1,500,000 36% $0 0% $4,180,084$0 0% $0 0% $0 0% $0 0% $0 0% $9,449,635$0 0% -- -- -- -- -- -- -- -- $0

$11,000,000 8% $0 0% $10,500,000 8% $15,000,000 11% $0 0% $131,374,926$2,541,600 5% $2,027,000 4% $11,587,504 23% $1,257,439 2% $18,182 0.04% $51,358,755

$0 0% -- -- -- -- -- -- -- -- $69,355$0 0% $0 0% $440,535 11% $1,700,000 41% $0 0% $4,114,682

$770,295 14% $0 0% $701,800 13% $3,110,139 58% $0 0% $5,371,592$5,411,162 10% $0 0% $14,850,000 28% $1,987,000 4% $0 0% $53,939,883

$0 0% $195,000 0% $0 0% $35,000,000 76% $0 0% $45,773,323$923,948 19% $0 0% $547,982 11% $1,500,000 31% $0 0% $4,830,439

$0 0% $0 0% $10,829,714 47% $9,483,459 42% $0 0% $22,835,557$0 0% -- -- -- -- -- -- -- -- $4,830,922

$3,034,961 8% $5,500 0.01% $0 0% $13,690,044 37% $0 0% $37,362,491$0 0% $0 0% $50,000 2% $1,200,000 50% $0 0% $2,424,065$0 0% -- -- -- -- -- -- -- -- $826$0 0% $0 0% $0 0% $42,930,000 63% $14,385 0.02% $68,017,127$0 0% $250,000 1% $1,893,375 8% $7,500,000 31% $0 0% $24,070,089$0 0% $0 0% $0 0% $29,000,000 70% $0 0% $41,409,633$0 0% $0 0% $0 0% $4,000,000 40% $0 0% $10,064,066$0 0% -- -- -- -- -- -- -- -- $7,603,480$0 0% $0 0% $3,290,796 8% $25,692,980 66% $227,606 1% $39,083,769

$232,287 17% $0 0% $200,000 15% $400,000 29% $38,350 3% $1,375,518$0 0% $0 0% $900,000 26% $900,000 26% $0 0% $3,470,631$0 0% $0 0% $625,278 5% $3,108,250 27% $0 0% $11,564,891$0 0% $0 0% $0 0% $3,200,000 77% $0 0% $4,165,194

$5,758,130 6% $0 0% $0 0% $54,000,000 58% $0 0% $93,647,360$0 0% $0 0% $0 0% $0 0% $4,142 0.2% $2,303,598$0 0% $8,796,739 2% $28,750,000 8% $195,910,268 52% $17,500,000 5% $375,444,243

$3,000,000 5% $0 0% $14,797,144 26% $10,000,000 17% $3,700,000 6% $57,459,630$0 0% $0 0% $0 0% $1,200,000 83% $0 0% $1,437,458$0 0% -- -- -- -- -- -- -- -- $9,082$0 0% $0 0% $650,000 2% $8,000,000 28% $4,000,000 14% $28,529,871$0 0% $0 0% $786,000 5% $6,000,000 37% $4,000,000 25% $16,013,111$0 0% $0 0% $123,724 0.3% $4,667,629 13% $26,879,096 74% $36,315,598$0 0% $0 0% $6,000,000 6% $60,500,000 64% $0 0% $95,045,318

$3,596,177 15% $0 0% $0 0% $919,280 4% $15,536 0.1% $23,754,044$0 0% -- -- -- -- -- -- -- -- $653$0 0% -- -- -- -- -- -- -- -- $1,918,436$0 0% $0 0% $5,658,856 17% $14,000,000 42% $0 0% $33,567,631$0 0% $0 0% $0 0% $1,180,000 74% $0 0% $1,598,316

$7,485,930 15% $747,794 2% $7,200,000 15% $11,500,000 24% $0 0% $48,837,811$0 0% $152,221 0.1% $32,010,159 26% $22,800,000 19% $318,120 0.3% $120,889,316

$1,327,143 21% $0 0% $0 0% $1,500,000 24% $443,366 7% $6,360,342$0 0% -- -- -- -- -- -- -- -- $370,720$0 0% -- -- -- -- -- -- -- -- $537,207

$11,000,000 22% $116,644 0.2% $5,681,266 11% $10,020,375 20% $0 0% $49,697,868$0 0% $0 0% $4,905,231 13% $16,148,254 41% $8,160,297 21% $38,935,074$0 0% $0 0% $0 0% $5,200,000 79% $0 0% $6,600,315

$412,461 1% $0 0% $6,345,520 23% $15,620,685 56% $0 0% $27,812,566$0 0% $0 0% $367,500 25% $549,427 38% $14,116 1% $1,464,830

$72,611,510 3% $12,290,898 1% $233,240,013 11% $960,335,569 43% $68,171,727 3% $2,212,331,573

Table 2: Total ADAP Budget, by State and by Source, FY2014 (continued)

39

State/Territory 2013 Part B ADAP Earmark

2014 Part B ADAP Earmark

% Change

2013 Part B ADAP Supplemental

2014 Part B ADAP Supplemental 1

% Change

2013 Part B Base Contribution Directed

to ADAP

2014 Part B Base Contribution Directed

to ADAP

% Change

2013 Part B Supplemental

Directed to ADAP

2014 Part B Supplemental Directed

to ADAP% Change 2013 ADAP

Emergency Funding

Alabama $9,747,521 $10,035,042 3% $796,339 $796,339 0% $321,420 $0 -100% $155,153 $0 -100% $3,434,816Alaska $562,869 $544,108 -3% $45,984 $51,071 11% $0 $0 0% $0 $8,871 100% $247,239American Samoa $1,651 $1,651 0% $0 $0 0% -- -- -- -- -- -- --Arizona $10,543,186 $10,822,719 3% $861,342 $0 -100% $0 $0 0% $194,284 $0 -100% $792,146Arkansas $4,173,720 $4,024,255 -4% $331,264 $331,264 0% $0 $0 0% $64,621 $0 -100% $0California $98,380,203 $97,901,516 0% $7,713,428 $9,189,227 19% $1,494,000 $1,500,000 0.4% $1,738,531 $0 -100% $10,761,268Colorado $9,509,736 $9,727,071 2% $776,913 $0 -100% $0 $0 0% $0 $0 0% $1,058,652Connecticut $10,149,812 $9,109,479 -10% $0 $0 0% $0 $0 0% $0 $33,713 100% $0Delaware $2,910,559 $2,680,084 -8% $0 $0 0% -- $0 -- -- $0 -- --District of Columbia $14,092,127 $9,449,635 -33% $0 $0 0% $561,264 $0 -100% $0 $0 0% $0Federated States of Micronesia $0 $0 0% $0 $0 0% -- -- -- -- -- -- --Florida $83,986,318 $85,493,534 2% $6,861,392 $6,681,392 0% $4,000,000 $2,700,000 -33% $2,920,207 $0 -100% $13,093,050Georgia $31,611,268 $31,015,825 -2% $0 $2,911,205 100% $0 $0 0% $566,494 $0 -100% $11,129,428Guam $80,040 $69,355 -13% $0 $0 0% $2,960 -- -- $0 -- -- $0Hawaii $1,962,973 $1,974,147 1% $0 $0 0% $0 $0 0% $0 $0 0% $0Idaho $690,075 $721,625 5% $56,377 $67,733 20% $0 $0 0% $0 $0 0% $770,295Illinois $27,692,804 $28,972,323 5% $2,262,406 $2,719,398 20% $0 $0 0% $0 $0 0% $5,411,162Indiana $7,545,100 $7,777,694 3% $616,409 $730,029 18% $1,967,001 $2,070,600 5% $0 $0 0% $0Iowa $1,616,273 $1,697,552 5% $132,044 $132,044 0% $0 $0 0% $0 $28,913 100% $923,948Kansas $2,415,263 $2,522,384 4% $0 $0 0% $0 $0 0% $0 $0 0% $0Kentucky $4,701,657 $4,830,922 3% $384,109 $0 -100% -- -- -- $0 -- -- $0Louisiana $15,699,628 $16,057,388 2% $1,282,605 $1,282,605 0% $1,500,000 $1,832,193 22% $541,649 $1,459,800 170% $4,181,655Maine $989,385 $1,017,210 3% $0 $0 0% $119,673 $156,855 31% $0 $0 0% $0Marshall Islands $826 $826 0% $0 $0 0% -- -- -- -- -- -- --Maryland $27,565,018 $25,072,742 -9% $0 $0 0% $0 $0 0% $0 $0 0% $0Massachusetts $13,917,303 $14,426,714 4% $0 $0 0% $0 $0 0% $0 $0 0% $0Michigan $12,420,524 $12,409,633 -0.1% $0 $0 0% $0 $0 0% $0 $0 0% $0Minnesota $5,800,789 $5,979,412 3% $0 $0 0% $12,343 $20,383 65% $80,795 $64,271 -20% $0Mississippi $7,481,081 $7,603,480 2% $0 $0 0% $0 -- -- $0 -- -- $0Missouri $9,673,525 $9,872,387 2% $0 $0 0% -- $0 -- $0 $0 0% $0Montana $341,712 $362,464 6% $27,917 $27,917 0% $187,582 $114,500 -39% $0 $0 0% $436,954Nebraska $1,498,212 $1,545,631 3% $122,399 $125,000 2% -- $0 -- -- $0 -- --Nevada $5,990,352 $6,118,122 2% $0 $0 0% -- $1,713,241 -- $0 $0 0% $0New Hampshire $966,937 $965,194 -0.2% $0 $0 0% $0 $0 0% $0 $0 0% $0New Jersey $29,978,367 $30,442,819 2% $2,449,129 $2,449,129 0% $250,000 $0 -100% $1,033,447 $997,282 -3% $5,758,130New Mexico $2,215,724 $2,299,456 4% $0 $0 0% $0 $0 0% $0 $0 0% $0New York $110,870,226 $111,252,394 0.3% $0 $0 0% $1,910,583 $1,055,757 -45% $3,789,690 $12,179,085 221% $0North Carolina $21,617,647 $22,137,530 2% $1,766,087 $2,077,872 18% $0 $0 0% $378,372 $1,747,084 362% $3,000,000North Dakota $169,609 $174,214 3% $13,856 $13,856 0% $104,173 $49,388 -53% $0 $0 0% $0Northern Mariana Islands $9,082 $9,082 0% $0 $0 0% -- -- -- -- -- -- --Ohio $15,303,043 $15,879,871 4% $0 $0 0% $0 $0 0% $0 $0 0% $0Oklahoma $4,244,379 $4,401,580 4% $346,751 $0 -100% $811,668 $825,531 2% $0 $0 0% $0Oregon $4,524,566 $4,645,149 3% $0 $0 0% $0 $0 -- $0 $0 -- $0Pennsylvania $27,855,846 $28,128,501 1% $0 $0 0% $1,191,646 $416,817 -65% $0 $0 0% $0Puerto Rico $18,326,048 $15,924,457 -13% $1,304,273 $1,304,273 0% $2,506,143 $71,074 -97% $535,819 $1,923,247 72% $3,596,177Republic of Palau $653 $653 0% $0 $0 0% -- -- -- -- -- -- --Rhode Island $2,194,058 $1,776,815 -19% $141,621 $141,621 0% $339,235 -- -- $0 -- -- $0South Carolina $12,640,017 $12,876,129 2% $1,032,646 $1,032,646 0% $0 $0 0% $0 $0 0% $0South Dakota $377,463 $396,316 5% $30,837 $0 -100% $44,561 $22,000 -51% $0 $0 0% $313,699Tennessee $14,054,256 $14,034,527 -0.1% $1,148,184 $1,317,307 15% $5,096,140 $5,283,858 4% $269,140 $1,268,395 371% $3,367,526Texas $57,395,140 $59,979,065 5% $4,688,984 $5,629,751 20% $0 $0 0% $0 $0 0% $0Utah $2,053,598 $2,104,601 2% $167,772 $167,772 0% $690,363 $779,556 13% $37,894 $37,904 0.03% $1,327,143Vermont $362,929 $370,720 2% $0 $0 0% $0 -- -- $0 -- -- $0Virgin Islands (U.S.) $567,037 $497,046 -12% $41,026 $40,161 -2% $206,752 -- -- $0 -- -- $0Virginia $17,377,426 $17,906,035 3% $1,419,676 $1,680,695 18% $745,202 $2,969,329 298% $2,024 $323,524 15884% $4,984,251Washington $9,527,196 $9,721,292 2% $778,339 $0 -100% $0 $0 0% $0 $0 0% $0West Virginia $6,600,315 $1,400,315 -79% $0 $0 0% -- $0 -- -- $0 -- --Wisconsin $4,459,715 $4,579,097 3% $364,343 $429,803 18% $319,590 $425,000 33% $0 $0 0% $412,461Wyoming $228,639 $236,138 3% $18,679 $22,165 19% $0 $275,484 100% $0 $0 0% $0Total $787,671,426 $781,975,926 -1% $37,983,131 $41,352,275 9% $24,382,299 $22,281,566 -9% $12,308,120 $20,072,089 63% $75,000,0001 Part B ADAP Supplemental awards were provided to states that met federal eligibility criteria, applied for funding, and were able to meet the mandated matching requirement or receive a waiver.

Table 3: Major FY2014 Budget Categories Compared with FY2013

Note: 48 ADAPs reported data. American Samoa, Federated States of Micronesia, Kentucky, Marshall Islands, Mississippi, Northern Mariana Islands, Republic of Palau, Rhode Island and Vermont did not respond. This table does not include the "Other State or Federal" category ($68,171,727), which is reported in the total budget in Tables 1 and 2. A dash (--) indicates the ADAP did not report data.

40

2014 ADAP Emergency Funding

% Change

2013 Part A Contribution Directed

to ADAP

2014 Part A Contribution Directed

to ADAP

% Change

2013 State Contribution

2014 State Contribution % Change 2013 Estimated

Drug Rebates2014 Estimated Drug

Rebates % Change

$3,638,484 6% $0 $0 0% $4,400,000 $4,306,645 -2% $1,000,000 $1,000,000 0%$686,786 178% $0 $0 0% $0 $0 0% $0 $0 0%

$0 -- -- -- -- -- -- -- -- -- --$792,146 0% $0 $0 0% $1,000,000 $1,000,000 0% $23,651,916 $15,547,202 -34%

$0 0% $0 $0 0% $82,816 $82,816 0% $800,000 $995,000 24%$11,000,000 2% $0 $0 0% $34,025,412 $53,644,944 58% $272,266,735 $278,601,026 2%

$0 -100% $0 $0 0% $4,477,589 $4,513,224 1% $4,710,000 $4,200,000 -11%$0 0% $0 $0 0% $0 $0 0% $16,361,893 $18,117,112 11%$0 -- -- $0 -- -- $0 -- -- $1,500,000 --$0 0% $0 $0 0% $0 $0 0% $0 $0 0%$0 -- -- -- -- -- -- -- -- -- --

$11,000,000 -16% $0 $0 0% $13,500,000 $10,500,000 -22% $11,000,000 $15,000,000 36%$2,541,600 -77% $0 $2,027,000 100% $8,502,400 $11,587,504 36% $100,000 $1,257,439 1157%

$0 0% $0 -- -- $0 -- -- $0 -- --$0 0% $0 $0 0% $440,000 $440,535 0.1% $1,325,000 $1,700,000 28%

$770,295 0% $0 $0 0% $801,800 $701,800 -12% $3,300,000 $3,110,139 -6%$5,411,162 0% $0 $0 0% $14,000,000 $14,850,000 6% $1,978,888 $1,987,000 0.4%

$0 0% $171,828 $195,000 13% $0 $0 0% $20,225,000 $35,000,000 73%$923,948 0% $0 $0 0% $547,982 $547,982 0% $932,000 $1,500,000 61%

$0 0% $0 $0 0% $3,000,000 $10,829,714 261% $8,000,000 $9,483,459 19%$0 0% $0 -- -- $0 -- -- $6,000,000 -- --

$3,034,961 -27% $0 $5,500 100% $0 $0 0% $2,100,000 $13,690,044 552%$0 0% $0 $0 0% $50,000 $50,000 0% $1,200,000 $1,200,000 0%$0 -- -- -- -- -- -- -- -- -- --$0 0% $0 $0 0% $0 $0 0% $38,777,443 $42,930,000 11%$0 0% $1,265,954 $250,000 -80% $1,893,375 $1,893,375 0% $7,500,000 $7,500,000 0%$0 0% $0 $0 0% $0 $0 0% $28,500,000 $29,000,000 2%$0 0% $0 $0 0% $1,064,718 $0 -100% $4,044,272 $4,000,000 -1%$0 0% $0 -- -- $750,000 -- -- $180,000 -- --$0 0% $0 $0 0% $3,809,187 $3,290,796 -14% $25,767,602 $25,692,980 -0.3%

$232,287 -47% $0 $0 0% $129,000 $200,000 55% $200,000 $400,000 100%$0 -- -- $0 -- -- $900,000 -- -- $900,000 --$0 0% $0 $0 0% $1,817,901 $625,278 -66% $5,102,386 $3,108,250 -39%$0 0% $500,874 $0 -100% $180,000 $0 -100% $3,000,000 $3,200,000 7%

$5,758,130 0% $0 $0 0% $0 $0 0% $52,000,000 $54,000,000 4%$0 0% $0 $0 0% $900,000 $0 -100% $0 $0 0%$0 0% $8,796,739 $8,796,739 0% $33,570,000 $28,750,000 -14% $162,843,917 $195,910,268 20%

$3,000,000 0% $0 $0 0% $20,583,490 $14,797,144 -28% $5,000,000 $10,000,000 100%$0 0% $0 $0 0% $0 $0 0% $1,200,000 $1,200,000 0%$0 -- -- -- -- -- -- -- -- -- --$0 0% $0 $0 0% $650,000 $650,000 0% $6,500,000 $8,000,000 23%$0 0% $0 $0 0% $1,560,725 $786,000 -50% $5,500,000 $6,000,000 9%$0 0% $0 -- -- $20,000 $123,724 519% $4,935,000 $4,667,629 -5%$0 0% $0 $0 0% $10,267,000 $6,000,000 -42% $42,664,063 $60,500,000 42%

$3,596,177 0% $0 $0 0% $882,325 $0 -100% $128,900 $919,280 613%$0 -- -- -- -- -- -- -- -- -- --$0 0% $0 -- -- $70,000 -- -- $1,225,000 -- --$0 0% $0 $0 0% $5,658,856 $5,658,856 0% $11,000,000 $14,000,000 27%$0 -100% $0 $0 0% $0 $0 0% $1,000,541 $1,180,000 18%

$7,485,930 122% $70,637 $747,794 959% $7,200,000 $7,200,000 0% $8,400,000 $11,500,000 37%$0 0% $810,025 $152,221 -81% $31,801,174 $32,010,159 1% $22,800,000 $22,800,000 0%

$1,327,143 0% $0 $0 0% $0 $0 0% $2,000,000 $1,500,000 -25%$0 0% $0 -- -- $0 -- -- $500,000 -- --$0 0% $0 -- -- $200,000 -- -- $0 -- --

$11,000,000 121% $1,452,525 $116,644 -92% $7,964,049 $5,681,266 -29% $6,680,962 $10,020,375 50%$0 0% $0 $0 0% $6,732,204 $4,905,231 -27% $16,765,527 $16,148,254 -4%$0 -- -- $0 -- -- $0 -- -- $5,200,000 --

$412,461 0% $0 $0 0% $1,306,220 $6,345,520 386% $16,055,000 $15,620,685 -3%$0 0% $0 $0 0% $367,500 $367,500 0% $549,427 $549,427 0%

$72,611,510 -3% $13,068,582 $12,290,898 -6% $224,205,723 $233,240,013 4.03% $855,771,471 $960,335,569 12%

Table 3: Major FY2014 Budget Categories Compared with FY2013 (continued)

41

State/Territory Private Insurance Medicaid Other Total

Alabama $151,860 $0 $0 $151,860Alaska $1,151,641 $0 $0 $1,151,641American Samoa -- -- -- --Arizona $0 $0 $0 $0Arkansas $0 $1,200 $0 $1,200California $0 $6,614,862 $92,487 $6,707,349Colorado $10,000 $125,000 $0 $135,000Connecticut $750,000 $3,000,000 $0 $3,750,000Delaware $0 $0 $0 $0District of Columbia $0 $0 $0 $0Federated States of Micronesia -- -- -- --Florida $0 $0 $0 $0Georgia $0 $0 $0 $0Guam -- -- -- --Hawaii $0 $0 $0 $0Idaho $0 $0 $0 $0Illinois $2,825,984 $18,408 $0 $2,844,392Indiana $0 $0 $0 $0Iowa $120,000 $160,000 $120,000 $400,000Kansas -- -- -- --Kentucky -- -- -- --Louisiana $0 $0 $0 $0Maine $0 $0 $0 $0Marshall Islands -- -- -- --Maryland $14,385 $0 $0 $14,385Massachusetts $0 $0 $0 $0Michigan $0 $1,597,843 $0 $1,597,843Minnesota $0 $0 $0 $0Mississippi -- -- -- --Missouri $93,735 $5,407,511 $25,769,151 $31,270,397Montana $0 $0 $0 $0Nebraska $10,000 $10,000 $0 $20,000Nevada $0 $0 $0 $0New Hampshire $0 $0 $0 $0New Jersey $6,000,000 $3,000,000 $0 $9,000,000New Mexico $0 $143,816 $63,305 $207,121New York $16,000,000 $1,500,000 $0 $17,500,000North Carolina $0 $0 $0 $0North Dakota $0 $0 $0 $0Northern Mariana Islands -- -- -- --Ohio $0 $0 $0 $0Oklahoma $70,000 $15,000 $0 $85,000Oregon $26,537,749 $0 $0 $26,537,749Pennsylvania $0 $0 $4,157,402 $4,157,402Puerto Rico $0 $20,000,000 $919,280 $20,919,280Republic of Palau -- -- -- --Rhode Island -- -- -- --South Carolina $104,823 $185,123 $0 $289,946South Dakota $0 $0 $0 $0Tennessee $0 $0 $0 $0Texas $0 $0 $0 $0Utah $0 $0 $0 $0Vermont -- -- -- --Virgin Islands (U.S.) -- -- -- --Virginia $0 $500000 $0 $500,000Washington $0 $0 $0 $0West Virginia $0 $20,187 $0 $20,187Wisconsin $214,930 $1,515,419 $0 $1,730,349Wyoming $0 $0 $0 $0Totals $52,903,466 $43,314,369 $31,121,625 $128,991,101Total # of ADAPs 14 18 6 19

Note: 47 ADAPs reported data. American Samoa, Federated States of Micronesia, Kansas, Kentucky, Marshall Islands, Mississippi, Northern Mariana Islands, Republic of Palau, Rhode Island and Vermont did not report data. A zero ($0) indicates the ADAP responded zero ($0) to the question.

Table 4: Cost Recovery and Other Cost-Saving Mechanisms (Excluding Drug Rebates), FY2013

42

43

Full-Pay Medications Only

ADAP-Funded Insurance

Program Only 4

Full-Pay Medications and ADAP-Funded

Insurance Program 5Prescription Drugs Prescription

Dispensing Costs

Alabama 2,949 823 2,867 82 0 $16,912,845 $283,669Alaska 129 20 46 44 33 $865,089 $80,597American Samoa -- -- -- -- -- -- --Arizona 3,003 692 1,274 1,154 393 $0 $426,964Arkansas 886 100 758 128 0 $4,373,331 $146,059California 41,192 4,550 19,682 17,344 0 $399,055,502 $2,013,080Colorado 3,995 507 1,071 1,523 933 $11,506,069 $321,058Connecticut 2,736 372 1,603 917 0 $24,994,396 $97,720Delaware 1,795 180 151 1,145 0 $3,160,987 $0District of Columbia 2,050 483 1,454 464 132 $11,887,965 $205,393Federated States of Micronesia -- -- -- -- -- -- --Florida 22,404 4,715 18,123 2,135 561 $129,319,159 $0Georgia 7,317 1,915 6,070 373 71 $53,692,061 $2,424,980Guam -- -- -- -- -- -- --Hawaii 481 94 190 163 89 $1,156,278 $71,644Idaho 289 67 265 0 0 $347,139 $0Illinois 9,091 1,636 7,074 569 609 $43,848,652 $1,593,137Indiana 2,950 917 430 732 1,788 $10,735,454 $35,113Iowa 815 142 387 206 171 $3,423,180 $190,251Kansas 1,546 147 440 586 226 $13,937,982 $50,878Kentucky -- -- -- -- -- -- --Louisiana 6,553 1,881 3,619 1,971 178 $19,304,927 $0Maine 903 99 32 581 83 $1,025,012 $3,840Marshall Islands -- -- -- -- -- -- --Maryland 7,165 627 3,312 2,261 907 $47,859,235 $380,458Massachusetts 8,178 771 281 6,747 10 $3,340,011 $4,519Michigan 5,312 922 2,674 2,638 0 $50,734,739 $220,863Minnesota 1,823 180 559 1,264 0 $5,794,075 $0Mississippi -- -- -- -- -- -- --Missouri 4,222 421 1,237 572 1,570 $32,059,083 $109,048Montana 283 65 164 83 36 $851,919 $19,370Nebraska 735 130 332 213 190 $3,580,645 $15,000Nevada 1,282 80 874 408 0 $7,752,423 $530,120New Hampshire 524 53 148 218 96 $2,169,608 $7,119New Jersey 8,226 988 5,913 1,781 0 $106,058,619 $871,142New Mexico 1,008 249 53 955 0 $198,893 $0New York 26,439 3,102 11,957 12,314 0 $316,285,434 $1,767,346North Carolina 8,514 1,734 6,651 1,106 293 $43,549,408 $2,238,131North Dakota 156 44 55 0 0 $1,372,489 $10,187Northern Mariana Islands -- -- -- -- -- -- --Ohio 6,563 621 2,652 2,098 903 $19,285,252 $4,150,345Oklahoma 1,794 285 582 684 438 $4,570,915 $337,440Oregon 3,569 416 0 3,411 158 $16,865,410 $2,505,898Pennsylvania 8,402 2,977 4,246 1,406 2,050 $84,248,770 $1,051,488Puerto Rico 7,964 1,147 7,446 518 0 $44,668,866 $37,740Republic of Palau -- -- -- -- -- -- --Rhode Island -- -- -- -- -- -- --South Carolina 5,737 929 3,754 1,340 281 $20,280,226 $1,045,160South Dakota 276 40 208 0 0 $1,811,115 $19,950Tennessee 6,091 808 2,961 2,324 806 $21,932,781 $625,198Texas 18,587 2,828 16,500 1,621 466 $100,244,624 $0Utah 747 199 457 130 126 $4,721,547 $200,075Vermont -- -- -- -- -- -- --Virgin Islands (U.S.) -- -- -- -- -- -- --Virginia 6,322 1,183 3,679 614 1,111 $18,524,013 $2,961,383Washington 4,855 479 372 2,946 744 $0 $0West Virginia 503 68 246 108 133 $5,355,799 $51,112Wisconsin 1,942 206 1,278 664 0 $21,383,800 $0Wyoming 166 29 -- -- -- $1,463,684 $11,990Total 258,469 40,921 144,127 78,541 15,585 $1,736,509,411 $27,115,465

Table 5: Total Clients Enrolled/Served and Program Expenditures, FY2013

Note: 48 ADAPs reported data. American Samoa, Federated States of Micronesia, Kentucky, Marshall Islands, Mississippi, Northern Mariana Islands, Republic of Palau, Rhode Island, Vermont and Virgin Islands (U.S.) did not respond, but their federal ADAP earmark and ADAP supplemental awards were known and incorporated. A dash (--) indicates the ADAP did not report data.

1 This table represents ADAP program expenditures in FY2013 (April 1, 2013-March 31, 2014). Only expenditure categories requested in the National ADAP Monitoring Survey are represented in this table.2 For some states, enrolled clients reported may be a snapshot in time rather than a cumulative unduplicated client count. In this instance, some ADAPs may report a higher number of clients served throughout the fiscal year compared to the number of clients enrolled in the program at the end of the fiscal year.

3 For the purposes of this report, ADAP clients are considered to be enrolled in either the full-pay medication program or the insurance program. Full-pay medication program clients are defined as those individuals who receive medications paid in full by ADAP with no coordination of insurance or benefits. Insurance program clients are defined as those who have additional coverage (i.e., insurance, Medicare) that ADAP is assisting through paying premiums, deductibles, or co-payments/co-insurance.4 Individuals who had an insurance (i.e., Medicare Part D, Medicaid, private insurance) payment (premium, co-payment/co-insurance, and/or deductible) paid on their behalf using ADAP funds, either fully or in part.5 This includes clients who enrolled in an insurance plan mid-year and those who were enrolled in an insurance plan that did not cover one or more medically necessary medications such that the ADAP’s full-pay prescription program did instead.6 This category may include HIV disease monitoring laboratory assays paid with ADAP funds as authorized under the HRSA flexibility policy.

7 “Other” includes, but is not limited to, contract services to dispense medications, determine eligibility, and manage enrollment; pharmacy charges, dispensing and shipping fees, central pharmacy fees; as well as medical, dental, lab, and nutritional services. Federal ADAP funds may not be used to pay for medical, dental, lab, and nutritional services.

FY2013 Clients Served 3

State/TerritoryFY2013 Clients

Enrolled 2

FY2013 New

Clients Enrolled

44

Insurance Premiums

Insurance Co-payments and

Deductibles

Client Outreach

Adherence and Monitoring 6

Quality Management

Program Administration Other 7 Total Expenditures

$0 $420,328 $68,661 $68,661 $311,816 $962,783 $0 $18,960,102$455,800 $0 $0 $60,885 $5,000 $55,209 $0 $1,522,580

-- -- -- -- -- -- -- --1,580,321 $4,688,937 $0 $0 $70,245 $1,517,307 $0 $8,283,774

$0 $330,974 $0 $0 $0 $127,104 $0 $4,977,468$12,333,351 $34,818,444 $0 $0 $0 $4,171,757 $6,990,312 $459,382,446$2,476,992 $2,450,177 $0 $211,980 $0 $899,898 $0 $17,866,174$1,085,512 $3,178,006 $0 $493,812 $242,344 $418,584 $170,965 $30,681,339$128,983 $0 $0 $0 $113,170 $282,457 $0 $3,685,597$853,206 $186,326 $0 $0 $0 $0 $0 $13,132,890

-- -- -- -- -- -- -- --$11,091,804 $7,981,358 $0 $0 $0 $5,791,586 $40,603 $154,224,510$3,253,225 $848,485 $0 $0 $0 $760,470 $0 $60,979,221

-- -- -- -- -- -- -- --$380,000 $440,596 $0 $0 $0 $46,055 $0 $2,094,573

$0 $0 $0 $0 $0 $0 $0 $347,139$1,949,451 $4,601,176 $0 $0 $0 $0 $0 $51,992,416$19,376,585 $727,558 $0 $0 $171,931 $1,153,053 $0 $32,199,694

$144,493 $577,974 $0 $0 $31,501 $201,439 $0 $4,568,838$374,577 $3,564,895 $0 $149,225 $0 $0 $0 $18,077,557

-- -- -- -- -- -- -- --$9,860,098 $0 $0 $0 $0 $0 $0 $29,165,025

356,504 $399,524 $0 $0 $32,080 $93,565 $9,752 $1,920,277-- -- -- -- -- -- -- --

$17,323,145 $13,407,018 $0 $1,490,001 $881,339 $2,246,364 $0 $83,587,560$7,847,449 $2,890,909 $0 $199,250 $0 $790,766 $0 $15,072,904$2,459,140 $551,140 $0 $350,754 $7,034 $0 $0 $54,323,670$3,586,978 $0 $112,744 $55,620 $157,197 $525,709 $0 $10,232,323

-- -- -- -- -- -- -- --$4,924,025 $4,322,371 $0 $0 $0 $0 $0 $41,414,527$111,169 $368,976 $0 $0 $0 $0 $0 $1,351,434$735,212 $735,212 $0 $0 $0 $282,000 $0 $5,348,069$952,163 $0 $31,461 $372,116 $0 $0 $0 $9,638,283

$0 $974,390 $0 $0 $0 $0 $0 $3,151,117$7,516,611 $6,463,557 $0 $0 $0 $1,100,000 $0 $122,009,929$3,867,106 $0 $0 $0 $0 $0 $0 $4,065,999$46,522,836 $0 $528,588 $608,629 $691,230 $2,846,246 $0 $369,250,309

$0 $2,812,694 $0 $0 $0 $414,008 $0 $49,014,241$0 $100,540 $0 $0 $0 $0 $0 $1,483,216-- -- -- -- -- -- -- --

$2,028,990 $451,861 $0 $0 $0 $817,526 $0 $26,733,974$1,695,379 $1,496,192 $0 $85,307 $14,086 $345,478 $0 $8,544,797$8,222,679 $2,459,387 $257,142 $9,838 $69,884 $2,151,257 $1,122,000 $33,663,495$377,220 $7,838,558 $0 $0 $0 $1,662,260 $0 $95,178,296

$0 $2,969,051 $0 $350,815 $100,346 $699,517 $0 $48,826,335-- -- -- -- -- -- -- ---- -- -- -- -- -- -- --

$831,143 $2,685,352 $0 $0 $0 $724,283 $0 $25,566,164$0 $2,249,057 $0 $0 $0 $0 $0 $4,080,122

$3,691,986 $2,839,198 $0 $0 $0 $890,106 $0 $29,979,269$0 $0 $0 $0 $0 $0 $0 $100,244,624

$465,449 $664,754 $0 $0 $34,643 $262,057 $0 $6,348,525-- -- -- -- -- -- -- ---- -- -- -- -- -- -- --

$1,726,094 $4,654,771 $0 $213,994 $323,645 $2,037,442 $0 $30,441,342$9,648,133 $0 $94,521 $2,945,405 $463,295 $1,493,947 $0 $14,645,301

$30,259 $0 $0 $0 $6,000 $0 $0 $5,443,170$3,154,996 $0 $48,490 $0 $2,585 $7,755 $0 $24,597,626

$0 $0 $0 $0 $0 $0 $0 $1,475,674$193,419,064 $126,149,746 $1,072,946 $7,666,292 $3,729,371 $35,777,988 $8,333,632 $2,139,773,915

Table 5: Total Clients Enrolled/Served and Program Expenditures, FY2013 (continued)

FY2013 ADAP Expenditures

45

Full-Pay Medications

Only


Only 2

Full-Pay Medications and

ADAP-Funded Insurance 3

Total Clients Served

Alabama 1,756 1,893 8% 1,496 1,803 90 0 1,893 27%Alaska 103 100 -3% 94 23 41 31 95 1%American Samoa -- -- -- -- -- -- -- -- --Arizona 2,267 1,592 -30% 1,831 374 870 0 1,244 -32%Arkansas 751 783 4% 560 675 108 0 783 40%California 31,726 31,164 -2% 22,702 10,774 9,618 0 20,392 -10%Colorado 3,541 2,155 -39% 2,265 299 1,462 2 1,763 -22%Connecticut 2,155 1,939 -10% 1,715 709 724 0 1,433 -16%Delaware -- 1,466 -- -- 82 621 0 703 --District of Columbia 1,499 1,622 8% 872 633 235 76 944 8%Federated States of Micronesia -- -- -- -- -- -- -- -- --Florida 16,229 17,308 7% 14,058 11,291 1,895 1 13,187 -6%Georgia 8,135 7,879 -3% 5,111 5,784 110 8 5,902 15%Guam 1 -- -- 1 -- -- -- -- --Hawaii 356 302 -15% 286 68 157 1 226 -21%Idaho 237 212 -11% 193 137 0 0 137 -29%Illinois 8,610 6,959 -19% 5,549 4,125 409 469 5,003 -10%Indiana 2,373 2,566 8% 2,326 363 2,203 0 2,566 10%Iowa 650 293 -55% 487 50 202 1 253 -48%Kansas 1,262 1,279 1% 678 137 552 0 689 2%Kentucky 2,165 -- -- 1,525 -- -- -- -- --Louisiana 4,376 5,555 27% 2,418 1,538 1,215 58 2,811 16%Maine 816 807 -1% 353 15 365 6 386 9%Marshall Islands -- -- -- -- -- -- -- -- --Maryland 6,349 6,045 -5% 3,691 1,247 2,127 0 3,374 -9%Massachusetts 5,641 6,232 10% 4,153 109 3,592 2 3,703 -11%Michigan 4,368 4,626 6% 2,557 905 1,514 0 2,419 -5%Minnesota 2,385 533 -78% 640 125 120 288 533 -17%Mississippi 1,393 -- -- 1,095 -- -- -- -- --Missouri 2,898 3,255 12% 2,209 492 1,229 776 2,497 13%Montana 1 221 240 9% 133 24 89 6 119 -11%Nebraska -- 621 -- -- 189 198 0 387 --Nevada 1,561 1,150 -26% 999 351 320 0 671 -33%New Hampshire 398 467 17% 159 91 135 59 285 79%New Jersey 6,492 5,858 -10% 5,083 3,349 140 0 3,489 -31%New Mexico 818 406 -50% 726 9 397 0 406 -44%New York 21,190 21,151 -0.2% 17,193 7,599 9,515 0 17,114 -0.5%North Carolina 6,734 6,910 3% 5,250 4,394 633 6 5,033 -4%North Dakota 144 153 6% 136 19 63 0 82 -40%Northern Mariana Islands -- -- -- -- -- -- -- -- --Ohio 5,048 5,159 2% 2,719 877 943 108 1,928 -29%Oklahoma 1,369 1,373 0.3% 1,031 80 1,025 38 1,143 11%Oregon 2,920 3,034 4% 2,849 3 2,780 2 2,785 -2%Pennsylvania 6,014 6,464 7% 4,653 2,978 1,596 511 5,085 9%Puerto Rico 6,183 6,947 12% 6,183 6,457 490 0 6,947 12%Republic of Palau -- -- -- -- -- -- -- -- --Rhode Island 774 -- -- 551 -- -- -- -- --South Carolina 4,640 4,854 5% 3,565 2,227 1,257 4 3,488 -2%South Dakota 196 231 18% 120 165 0 0 165 38%Tennessee 4,466 4,917 10% 2,945 2,541 2,204 172 4,917 67%Texas 17,110 18,069 6% 11,360 10,424 1,789 0 12,213 8%Utah 664 550 -17% 468 225 226 7 458 -2%Vermont 335 -- -- 165 -- -- -- -- --Virgin Islands (U.S.) 101 -- -- 101 -- -- -- -- --Virginia 4,985 5,192 4% 3,293 1,244 2,564 307 4,115 25%Washington 4,007 3,111 -22% 2,922 115 1,982 66 2,163 -26%West Virginia -- 408 -- -- 82 165 27 274 --Wisconsin 1,843 1,001 -46% 954 215 454 0 669 -30%Wyoming 156 157 1% 64 -- -- -- -- --Total 210,411 204,988 152,487 85,416 58,424 3,032 146,872Comparison Total 1 205,907 199,779 -3% 149,359 143,257 -4%

Table 6: Total Clients Enrolled and Served, June 2013 and June 2014

Note: 47 ADAPs reported data. American Samoa, Federated States of Micronesia, Kentucky, Marshall Islands, Mississippi, Northern Mariana Islands, Republic of Palau, Rhode Island, Vermont, Virgin Islands (U.S.) and Wyoming did not respond. A dash (--) indicates the ADAP did not report data.

State/Territory June 2013 Clients Enrolled

June 2014 Clients Enrolled % Change June 2013

Clients Served

June 2014 Clients Served 1

% Change

1 For the purposes of this report, ADAP clients are considered to be enrolled in either the full-pay medication program or the insurance program. Full-pay medication program clients are defined as those individuals who receive medications paid in full by ADAP with no coordination of insurance or benefits. Insurance program clients are defined as those who have additional coverage (i.e., insurance, Medicare) that ADAP is assisting through paying premiums, deductibles, or co-payments/co-insurance.2 Individuals who had an insurance (i.e., Medicare Part D, Medicaid, private insurance) payment (premium, co-payment/co-insurance, and/or deductible) paid on their behalf using ADAP funds, either fully or in part.3 This includes clients who enrolled in an insurance plan mid-year and those who were enrolled in an insurance plan that did not cover one or more medically necessary medications such that the ADAP’s full-pay prescription program did instead.

46

State/Territory June 2014 Clients Served Medicaid Medicaid and Medicare

Medicare Part D Full Subsidy 1

Medicare Part D Partial Subsidy

Medicare Part D Standard Benefit

Private Insurance Coverage

No Form of Insurance Unknown

Alabama 1,893 0 0 0 0 90 0 1,803 0

Alaska 95 0 0 0 1 9 62 23 0

American Samoa -- -- -- -- -- -- -- -- --

Arizona 1,244 1 318 9 8 30 513 365 0

Arkansas 783 0 0 0 108 0 0 675 0

California 20,392 216 1,526 121 148 2,425 5,182 10,774 0

Colorado 1,763 551 0 149 52 207 505 299 0

Connecticut 1,433 0 0 0 0 329 445 659 0

Delaware 703 374 0 24 8 50 165 82 0

District of Columbia 944 0 4 0 0 0 294 633 13

Federated States of Micronesia -- -- -- -- -- -- -- -- --

Florida 13,187 0 19 41 123 840 873 11,291 0

Georgia 5,902 19 0 74 124 387 131 5,098 69

Guam -- -- -- -- -- -- -- -- --Hawaii 226 0 0 2 3 48 105 68 0

Idaho 137 0 0 0 0 0 1 136 0

Illinois 5,003 580 10 0 0 0 878 3,535 0

Indiana 2,566 0 0 0 190 0 0 282 2,094

Iowa 253 0 24 0 0 16 163 50 0

Kansas 689 96 12 21 10 63 375 112 0

Kentucky -- -- -- -- -- -- -- -- --

Louisiana 2,811 0 0 0 0 314 804 1,538 155

Maine 386 242 12 0 0 22 99 11 0

Marshall Islands -- -- -- -- -- -- -- -- --

Maryland 3,374 0 0 150 31 136 1,810 1,247 0

Massachusetts 3,703 1,520 563 2 0 202 993 24 399

Michigan 2,419 218 0 0 192 268 1,054 687 0

Minnesota 533 0 0 0 50 130 228 125 0

Mississippi -- -- -- -- -- -- -- -- --

Missouri 2,497 91 6 7 2 29 1,943 419 0

Montana 119 0 2 0 14 3 75 25 0

Nebraska 387 0 0 10 5 29 157 186 0

Nevada 671 0 0 0 0 160 160 351 0

New Hampshire 285 40 7 15 17 48 119 39 0

New Jersey 3,489 0 0 0 0 0 140 3,349 0

New Mexico 406 0 6 27 20 78 266 9 0

New York 17,114 390 226 1,000 379 1,839 5,681 7,599 0

North Carolina 5,033 0 0 142 128 369 0 4,394 0

North Dakota 82 13 4 6 1 5 35 18 0

Northern Mariana Islands -- -- -- -- -- -- -- -- --

Ohio 1,928 99 0 103 55 262 532 877 0

Oklahoma 1,143 0 6 17 37 165 1,042 58 0

Oregon 2,785 882 82 509 86 281 942 3 0

Pennsylvania 5,085 147 42 0 0 0 1,621 2,178 1,097

Puerto Rico 6,947 6,313 0 0 0 0 490 144 0

Republic of Palau -- -- -- -- -- -- -- -- --

Rhode Island -- -- -- -- -- -- -- -- --

South Carolina 3,488 0 0 17 37 165 1,042 2,227 0

South Dakota 165 28 4 0 0 18 105 10 0

Tennessee 4,917 0 0 0 0 0 2,204 0 2,713

Texas 12,213 0 0 0 0 1,634 155 10,424 0

Utah 458 0 0 2 3 7 221 225 0

Vermont -- -- -- -- -- -- -- -- --

Virgin Islands (U.S.) -- -- -- -- -- -- -- -- --

Virginia 4,115 0 0 0 196 221 2,506 1,192 0

Washington 2,163 70 131 225 88 203 1,331 115 0

West Virginia 274 0 0 20 27 65 80 82 0

Wisconsin 669 11 7 33 8 74 321 215 0

Wyoming -- -- -- -- -- -- -- -- --Total 146,872 11,901 3,011 2,726 2,151 11,221 35,848 73,656 6,540

1 Asset limits for full- vs. partial-subsidy under Medicare Part D may be found here.


Table 7: ADAP Clients Served by Other Payers, June 2014

47

State/Territory June 2014 Clients Served

Non-Hispanic Black/African

American

Non-Hispanic

WhiteHispanic Asian

Native Hawaiian/Pacific

Islander

American Indian/Alaskan

NativeMulti-Racial Other Unknown

Alabama 1,893 66% 27% 3% 1% 4% 0.1% 0.1% 0.1% 0%Alaska 95 19% 56% 16% 6% 0% 3% 0% 0% 0%American Samoa -- -- -- -- -- -- -- -- -- --Arizona 1,244 8% 42% 42% 2% 0.2% 2% 4% 0% 0%Arkansas 783 40% 48% 2% 1% 1% 0.4% 7% 0% 2%California 20,392 9% 36% 47% 4% 0.3% 0.2% 2% 0% 0.3%Colorado 1,763 7% 16% 28% 1% 0% 1% 1% 47% 0%Connecticut 1,433 36% 56% 6% 1% 0% 0.1% 0% 0% 0%Delaware 703 64% 34% 1% 0% 0% 0% 2% 0% 0%District of Columbia 944 53% 8% 12% 1% 0% 0% 0% 1% 26%Federated States of Micronesia -- -- -- -- -- -- -- -- -- --Florida 13,187 42% 27% 30% 1% 0.1% 0.2% 0.2% 1% 0%Georgia 5,902 65% 22% 10% 1% 0% 0.1% 1% 1% 0%Guam -- -- -- -- -- -- -- -- -- --Hawaii 226 3% 54% 7% 19% 8% 1% 7% 0% 0%Idaho 137 4% 67% 23% 1% 1% 1% 3% 0% 1%Illinois 5,003 42% 27% 27% 2% 0.2% 0.1% 1% 2% 0.02%Indiana 2,566 33% 55% 7% 2% 0.04% 0.1% 1% 2% 0%Iowa 253 19% 57% 15% 5% 0% 1% 2% 0% 0%Kansas 689 27% 49% 20% 1% 1% 1% 0% 0% 0%Kentucky -- -- -- -- -- -- -- -- -- --Louisiana 2,811 63% 26% 5% 0.4% 0.1% 0.1% 2% 0% 3%Maine 386 18% 72% 5% 1% 0% 0.3% 3% 0% 0.3%Marshall Islands -- -- -- -- -- -- -- -- -- --Maryland 3,374 68% 17% 7% 1% 0.1% 0.2% 0.1% 6% 1%Massachusetts 3,703 26% 42% 26% 2% 0.1% 0.2% 1% 0% 3%Michigan 2,419 47% 43% 4% 1% 0.1% 1% 0% 1% 3%Minnesota 533 29% 44% 19% 3% 0% 0.4% 1% 0% 5%Mississippi -- -- -- -- -- -- -- -- -- --Missouri 2,497 49% 43% 7% 1% 0.2% 0% 0% 0% 0%Montana 119 3% 85% 3% 0% 1% 8% 0% 0% 0%Nebraska 387 21% 44% 23% 3% 1% 1% 0% 7% 0%Nevada 671 0% 0% 0% 0% 0% 0% 0% 0% 100%New Hampshire 285 16% 64% 12% 2% 0% 0.4% 4% 1% 0.4%New Jersey 3,489 48% 19% 27% 2% 1% 0% 3% 0% 0%New Mexico 406 4% 38% 52% 0.2% 1% 2% 1% 0.5% 1%New York 17,114 35% 26% 32% 2% 0.2% 0.4% 0% 0% 5%North Carolina 5,033 61% 27% 9% 0.2% 0.1% 1% 0.5% 1% 0%North Dakota 82 40% 55% 0% 0% 0% 5% 0% 0% 0%Northern Mariana Islands -- -- -- -- -- -- -- -- -- --Ohio 1,928 37% 52% 6% 1% 0% 0.1% 1% 0% 3%Oklahoma 1,143 19% 59% 10% 1% 0.3% 6% 5% 0% 0%Oregon 2,785 5% 65% 24% 1% 0.4% 1% 1% 1% 0.1%Pennsylvania 5,085 45% 40% 13% 1% 0.1% 0.2% 0% 1% 0%Puerto Rico 6,947 0% 0% 100% 0% 0% 0% 0% 0% 0%Republic of Palau -- -- -- -- -- -- -- -- -- --Rhode Island -- -- -- -- -- -- -- -- -- --South Carolina 3,488 67% 26% 5% 0.4% 0.1% 0.1% 1% 0% 0.2%South Dakota 165 28% 55% 5% 1% 0% 6% 4% 0% 0%Tennessee 4,917 53% 38% 5% 0.5% 0.02% 0.2% 0% 3% 0.04%Texas 12,213 28% 17% 37% 1% 0.01% 0.2% 0% 1% 16%Utah 458 8% 60% 29% 2% 0% 1% 0% 0.2% 0%Vermont -- -- -- -- -- -- -- -- -- --Virgin Islands (U.S.) -- -- -- -- -- -- -- -- -- --Virginia 4,115 58% 27% 11% 2% 0.2% 1% 0% 0% 1%Washington 2,163 12% 64% 13% 2% 1% 2% 4% 1% 0.5%West Virginia 274 31% 64% 5% 0% 0% 0% 0% 0% 0%Wisconsin 669 28% 45% 24% 2% 0.4% 1% 0% 0% 0.3%Wyoming -- -- -- -- -- -- -- -- -- --Total 146,872 35% 31% 28% 2% 0.2% 0.4% 1% 1% 3%

Note: 47 ADAPs reported data. American Samoa, Federated States of Micronesia, Kentucky, Marshall Islands, Mississippi, Northern Mariana Islands, Republic of Palau, Rhode Island, Vermont, Virgin Islands (U.S.) and Wyoming did not respond. A dash (--) indicates the ADAP did not report data. A zero (0%) indicates the ADAP responded zero (0%) to the question.

Table 8: ADAP Clients Served, by Race/Ethnicity, June 2014

48

State/Territory June 2014 Clients Served Male Female Transgender Unknown

Alabama 1,893 72% 28% 0% 0%Alaska 95 77% 23% 0% 0%American Samoa -- -- -- -- --Arizona 1,244 85% 14% 0.4% 0%Arkansas 783 81% 19% 0.1% 0%California 20,392 90% 9% 1% 0%Colorado 1,763 86% 13% 1% 0.1%Connecticut 1,433 72% 28% 0.1% 0%Delaware 703 61% 38% 0.1% 0%District of Columbia 944 75% 24% 1% 0%Federated States of Micronesia -- -- -- -- --Florida 13,187 75% 24% 0.5% 0%Georgia 5,902 75% 25% 0.1% 0%Guam -- -- -- -- --Hawaii 226 92% 8% 0% 0%Idaho 137 80% 20% 0% 0%Illinois 5,003 82% 17% 1% 0%Indiana 2,566 82% 18% 0% 0%Iowa 253 74% 26% 0.4% 0%Kansas 689 77% 23% 1% 0%Kentucky -- -- -- -- --Louisiana 2,811 70% 29% 1% 0%Maine 386 78% 22% 1% 0%Marshall Islands -- -- -- -- --Maryland 3,374 66% 34% 0.03% 0%Massachusetts 3,703 69% 30% 0.5% 0.1%Michigan 2,419 82% 18% 0.1% 0%Minnesota 533 75% 25% 0.2% 0%Mississippi -- -- -- -- --Missouri 2,497 81% 18% 1% 0%Montana 119 90% 10% 0% 0%Nebraska 387 78% 21% 1% 0%Nevada 671 0% 0% 0% 100%New Hampshire 285 76% 24% 0.4% 0%New Jersey 3,489 68% 32% 0.1% 0%New Mexico 406 90% 10% 0.2% 0%New York 17,114 77% 23% 0.3% 0%North Carolina 5,033 72% 27% 0.4% 0%North Dakota 82 68% 32% 0% 0%Northern Mariana Islands -- -- -- -- --Ohio 1,928 84% 15% 0.4% 0%Oklahoma 1,143 85% 15% 0% 0%Oregon 2,785 88% 12% 1% 0%Pennsylvania 5,085 77% 23% 0.5% 0%Puerto Rico 6,947 64% 36% 0% 0%Republic of Palau -- -- -- -- --Rhode Island -- -- -- -- --South Carolina 3,488 71% 28% 0.4% 0%South Dakota 165 63% 37% 0% 0%Tennessee 4,917 25% 75% 0.4% 0.04%Texas 12,213 19% 66% 1% 15%Utah 458 86% 14% 0.2% 0%Vermont -- -- -- -- --Virgin Islands (U.S.) -- -- -- -- --Virginia 4,115 72% 27% 1% 0.05%Washington 2,163 88% 11% 1% 0.4%West Virginia 274 75% 25% 0% 0%Wisconsin 669 82% 16% 2% 0%Wyoming -- -- -- -- --Total 146,872 71% 27% 0.4% 2%


Table 9: ADAP Clients Served, by Gender, June 2014

49


≤12 Years

13-24 Years

25-44 Years

45-64 Years

>64 Years Unknown

Alabama 1,893 0% 5% 57% 36% 1% 0%Alaska 95 0% 2% 41% 55% 2% 0%American Samoa -- -- -- -- -- -- --Arizona 1,244 0.1% 3% 37% 53% 6% 0%Arkansas 783 0% 7% 52% 39% 2% 0%California 20,392 0% 2% 38% 53% 8% 0%Colorado 1,763 0.3% 2% 39% 53% 6% 0%Connecticut 1,433 0% 2% 33% 58% 7% 0%Delaware 703 0% 2% 29% 64% 5% 0%District of Columbia 944 0% 2% 36% 54% 8% 0%Federated States of Micronesia -- -- -- -- -- -- --Florida 13,187 0.02% 4% 38% 54% 4% 0%Georgia 5,902 0.1% 5% 46% 47% 2% 0%Guam -- -- -- -- -- -- --Hawaii 226 0% 0% 25% 59% 16% 0%Idaho 137 0% 6% 53% 39% 1% 0%Illinois 5,003 0.1% 4% 49% 45% 2% 0%Indiana 2,566 0.1% 6% 46% 45% 3% 0%Iowa 253 0% 3% 47% 46% 4% 0%Kansas 689 1% 5% 44% 46% 4% 0%Kentucky -- -- -- -- -- -- --Louisiana 2,811 0% 6% 47% 45% 3% 0%Maine 386 0% 1% 33% 61% 5% 0%Marshall Islands -- -- -- -- -- -- --Maryland 3,374 0.1% 2% 34% 55% 9% 0%Massachusetts 3,703 0.03% 1% 24% 67% 8% 0.1%Michigan 2,419 0.4% 4% 38% 52% 5% 0%Minnesota 533 1% 4% 39% 50% 6% 0%Mississippi -- -- -- -- -- -- --Missouri 2,497 0.2% 8% 53% 38% 1% 0%Montana 119 0% 2% 40% 54% 4% 0%Nebraska 387 1% 4% 47% 46% 3% 0%Nevada 671 0% 0% 0% 0% 0% 100%New Hampshire 285 0.4% 2% 28% 64% 6% 0%New Jersey 3,489 0% 6% 40% 52% 2% 0%New Mexico 406 0.2% 2% 29% 67% 2% 0%New York 17,114 0.02% 2% 36% 54% 7% 0%North Carolina 5,033 0% 5% 45% 47% 4% 0%North Dakota 82 1% 7% 65% 26% 1% 0%Northern Mariana Islands -- -- -- -- -- -- --Ohio 1,928 0% 4% 39% 52% 6% 0%Oklahoma 1,143 0% 4% 40% 53% 3% 0%Oregon 2,785 0.1% 2% 37% 56% 5% 0%Pennsylvania 5,085 0.02% 4% 36% 54% 6% 0%Puerto Rico 6,947 0.1% 4% 32% 61% 3% 0%Republic of Palau -- -- -- -- -- -- --Rhode Island -- -- -- -- -- -- --South Carolina 3,488 0.2% 6% 43% 48% 3% 0%South Dakota 165 1% 1% 39% 56% 3% 0%Tennessee 4,917 0.1% 8% 49% 42% 1% 0%Texas 12,213 0.1% 4% 46% 35% 1% 15%Utah 458 0% 1% 53% 44% 2% 0%Vermont -- -- -- -- -- -- --Virgin Islands (U.S.) -- -- -- -- -- -- --Virginia 4,115 0.02% 7% 42% 48% 3% 0.05%Washington 2,163 0% 0.3% 29% 63% 8% 0%West Virginia 274 0% 3% 26% 64% 7% 0%Wisconsin 669 1% 6% 43% 45% 5% 0%Wyoming -- -- -- -- -- -- --Total 146,872 0.1% 4% 40% 50% 5% 2%


Table 10: ADAP Clients Served, by Age, June 2014

50

Full-Pay Medications (Uninsured)

ADAP-Funded Insurance Program

Alabama 250% FPL 250% FPL 1,893 90% 4% 4% 2% 0.0% 0% 0%Alaska 300% FPL 300% FPL 95 39% 16% 18% 27% 0% 0% 0%American Samoa -- -- -- -- -- -- -- -- -- --Arizona 300% FPL 300% FPL 1,244 23% 11% 34% 32% 0% 0% 0%Arkansas 400% FPL 400% FPL 783 53% 15% 22% 8% 1% 0% 0%California 500% FPL 500% FPL 20,392 29% 11% 24% 23% 12% 1% 0.1%Colorado 500% FPL 400% FPL 1,763 41% 13% 20% 19% 7% 0.1% 0%Connecticut 400% FPL 400% FPL 1,433 0% 0% 0% 0% 0% 0% 100%Delaware 500% FPL 500% FPL 703 52% 10% 16% 14% 7% 2% 0%District of Columbia 500% FPL 500% FPL 944 28% 9% 14% 18% 11% 4% 15%Federated States of Micronesia -- -- -- -- -- -- -- -- -- --Florida 400% FPL 400% FPL 13,187 51% 13% 19% 14% 4% 0% 0%Georgia 300% FPL 300% FPL 5,902 53% 15% 18% 12% 0.02% 0% 2%Guam -- -- -- -- -- -- -- -- -- --Hawaii 400% FPL 400% FPL 226 23% 17% 36% 21% 3% 0% 0%Idaho 200% FPL NA 137 62% 22% 16% 0% 0% 0% 0%Illinois 300% FPL 450% FPL 5,003 52% 11% 16% 14% 5% 2% 0%Indiana 300% FPL 300% FPL 2,566 50% 15% 20% 15% 0.3% 0.1% 0%Iowa 200% FPL 400% FPL 253 14% 9% 36% 33% 8% 0.4% 0%Kansas 300% FPL 300% FPL 689 39% 13% 23% 25% 0% 0% 0%Kentucky -- -- -- -- -- -- -- -- -- --Louisiana 300% FPL 300% FPL 2,811 53% 14% 20% 13% 0% 0% 0%Maine 500% FPL 500% FPL 386 47% 9% 15% 18% 8% 3% 0%Marshall Islands -- -- -- -- -- -- -- -- -- --Maryland 500% FPL 500% FPL 3,374 8% 8% 22% 29% 21% 12% 0%Massachusetts 500% FPL 2 500% FPL 2 3,703 44% 9% 15% 16% 10% 7% 0%Michigan 450% FPL 400% FPL 2,419 13% 8% 26% 33% 13% 7% 0.2%Minnesota 300% FPL 300% FPL 533 24% 5% 26% 45% 0% 0% 0%Mississippi -- -- -- -- -- -- -- -- -- --Missouri 300% FPL 300% FPL 2,497 52% 11% 18% 19% 0.2% 0.04% 0%Montana 430% FPL 430% FPL 119 40% 27% 13% 12% 4% 1% 3%Nebraska 200% FPL 200% FPL 387 58% 20% 22% 0% 0% 0% 0%Nevada 400% FPL 400% FPL 671 0% 0% 0% 0% 0% 0% 100%New Hampshire 400% FPL 400% FPL 285 34% 14% 24% 21% 7% 0% 0%New Jersey 500% FPL 500% FPL 3,489 31% 9% 18% 23% 13% 7% 0%New Mexico 400% FPL 400% FPL 406 28% 11% 31% 27% 4% 0% 0%New York 435% FPL 435% FPL 17,114 32% 14% 21% 20% 11% 2% 0%North Carolina 300% FPL 300% FPL 5,033 55% 15% 20% 10% 0% 0% 0%North Dakota 300% FPL 300% FPL 82 23% 18% 22% 28% 7% 1% 0%Northern Mariana Islands -- -- -- -- -- -- -- -- -- --Ohio 300% FPL 300% FPL 1,928 30% 14% 32% 23% 0% 0% 1%Oklahoma 200% FPL 400% FPL 1,143 43% 12% 20% 11% 2% 0% 12%Oregon 400% FPL 400% FPL 2,785 47% 17% 19% 13% 4% 0% 0%Pennsylvania 500% FPL 3 500% FPL 3 5,085 27% 11% 19% 23% 13% 8% 0%Puerto Rico 200% FPL 200% FPL 6,947 93% 7% 0% 0% 0% 0% 0%Republic of Palau -- -- -- -- -- -- -- -- -- --Rhode Island -- -- -- -- -- -- -- -- -- --South Carolina 300% FPL 550% FPL 3,488 48% 11% 17% 15% 5% 3% 0%South Dakota 300% FPL NA 165 44% 15% 21% 20% 0% 0% 0%Tennessee 300% FPL 300% FPL 4,917 57% 13% 14% 16% 1% 0% 0%Texas 200% FPL 200% FPL 12,213 79% 2% 4% 0% 0% 0% 15%Utah 250% FPL 250% FPL 458 54% 12% 19% 13% 0% 0% 1%Vermont -- -- -- -- -- -- -- -- -- --Virgin Islands (U.S.) -- -- -- -- -- -- -- -- -- --Virginia 400% FPL 400% FPL 4,115 59% 12% 15% 10% 3% 0% 0.4%Washington 400% FPL 400% FPL 2,163 13% 10% 37% 34% 6% 0% 0%West Virginia 400% FPL 400% FPL 274 0% 15% 47% 32% 5% 0% 0%Wisconsin 300% FPL 300% FPL 669 31% 14% 25% 30% 0% 0% 1%Wyoming 350% FPL 350% FPL -- -- -- -- -- -- -- --

146,872 45% 11% 18% 16% 6% 2% 3%

Table 11: ADAP Clients Served, by Income Level, June 2014

Unknown

Total

301-400% FPL >401% FPL

3 In Pennsylvania, clients at >500% FPL who have dependents have an allowance for those dependents that account for income over the determined limit.

2 In Massachusetts, the 500% FPL income eligibilty requirement also includes a $5,060 allowance for each dependent.

Note: 47 ADAPs reported data. American Samoa, Federated States of Micronesia, Kentucky, Marshall Islands, Mississippi, Northern Mariana Islands, Republic of Palau, Rhode Island, Vermont, Virgin Islands (U.S.) and Wyoming did not respond. A dash (--) indicates the ADAP did not report data. A zero (0%) indicates the ADAP responded zero (0%) to the question. The 2014 Federal Poverty Level (FPL) was $11,670 (slightly higher in Alaska and Hawaii) for a household of one.

1 In 2014, the ACA expands Medicaid eligibility to most people with income up to 133% of the federal poverty level (FPL). However, in addition to new income counting rules for most Medicaid populations (called “Modified Adjusted Gross Income”), there is an additional 5% disregard of income, effectively bumping the Medicaid income eligibility threshold to 138% FPL.

State/Territory

Financial Eligibility June 2014

Clients Served ≤100% FPL 101-138% 1 FPL

139-200% FPL

201-300% FPL

51

Alabama 1,893 -- -- -- 0% -- --Alaska 95 -- -- -- 0% -- --American Samoa -- -- -- -- -- -- --Arizona 1,244 15% 34% 0% -- 7% 10%Arkansas 783 66% 7% 0% -- 8% 1%California 20,392 24% 19% 0% -- 11% 8%Colorado 1,763 9% 46% 0.1% -- 0.1% 0.2%Connecticut 1,433 -- -- -- 59% -- --Delaware 703 -- -- -- 31% -- --District of Columbia 944 -- -- -- 0% -- --Federated States of Micronesia -- -- -- -- -- -- --Florida 13,187 30% 5% 0% -- 48% 9%Georgia 5,902 54% 1% 0.1% -- 13% 0.3%Guam -- -- -- -- -- -- --Hawaii 226 22% 35% 0.4% -- 0% 0%Idaho 137 -- -- -- 64% -- --Illinois 5,003 65% 6% 7% -- 4% 0.1%Indiana 2,566 -- -- -- 55% -- --Iowa 253 -- -- -- 51% -- --Kansas 689 9% 38% 0% -- 2% 6%Kentucky -- -- -- -- -- -- --Louisiana 2,811 -- -- -- 42% -- --Maine 386 3% 50% 1% -- 1% 9%Marshall Islands -- -- -- -- -- -- --Maryland 3,374 0.1% 0.03% 0% -- 25% 42%Massachusetts 3,703 2% 48% 0.03% -- 1% 4%Michigan 2,419 -- -- -- 41% -- --Minnesota 533 -- -- -- 0% -- --Mississippi -- -- -- -- -- -- --Missouri 2,497 9% 24% 15% -- 5% 12%Montana 119 -- -- -- 46% -- --Nebraska 387 -- -- -- 0% -- --Nevada 671 -- -- -- 0% -- --New Hampshire 285 -- -- -- 52% -- --New Jersey 3,489 -- -- -- 0% -- --New Mexico 406 1% 39% 0% -- 0% 1%New York 17,114 -- -- -- 28% -- --North Carolina 5,033 54% 6% 0.1% -- 6% 0.4%North Dakota 82 13% 44% 0% -- 0% 0%Northern Mariana Islands -- -- -- -- -- -- --Ohio 1,928 30% 34% 4% -- 0% 0%Oklahoma 1,143 -- -- -- 52% -- --Oregon 2,785 0.04% 7% 0% -- 0.04% 36%Pennsylvania 5,085 0% 0% 0% -- 17% 14%Puerto Rico 6,947 -- -- -- 0% -- --Republic of Palau -- -- -- -- -- -- --Rhode Island -- -- -- -- -- -- --South Carolina 3,488 33% 19% 0% -- 3% 1%South Dakota 165 -- -- -- 85% -- --Tennessee 4,917 -- -- -- 60% -- --Texas 12,213 -- -- -- 0% -- --Utah 458 32% 36% 1% -- 0% 0.2%Vermont -- -- -- -- -- -- --Virgin Islands (U.S.) -- -- -- -- -- -- --Virginia 4,115 16% 37% 4% -- 2% 2%Washington 2,163 -- -- -- 6% -- --West Virginia 274 -- -- -- 57% -- --Wisconsin 669 -- -- -- 42% -- --Wyoming -- -- -- -- -- -- --Total 146,872 26% 22% 34% 10% 14% 12%

Table 12: ADAP Clients Served, by HIV/AIDS Status, June 2014

3 The AIDS case definition used as part of this Survey may be found here and is consistent with the most recent ADR submission. Please note, however, that an updated case definition was released by CDC in April 2014 (located here).

Note: 47 ADAPs reported data. American Samoa, Federated States of Micronesia, Kentucky, Marshall Islands, Mississippi, Northern Mariana Islands, Republic of Palau, Rhode Island, Vermont, Virgin Islands (U.S.) and Wyoming did not respond. A dash (--) indicates the ADAP did not report data. A zero (0%) indicates the ADAP responded zero (0%) to the question. In some cases, an ADAP was able to report data though was unable to distinguish between clients served by the full-pay medications program only, the ADAP-funded insurance program only, and the full-pay medications and ADAP-funded insurance programs.

Note: Many ADAPs were unable to report HIV/AIDS Status separately for: clients served by a full-pay prescription program only; clients served by an ADAP-funded insurance program only; and clients served by a fully-pay prescription program and ADAP-funded insurance program. As such, the percentage of clients that fall into each HIV/AIDS Status category are reported under "All Clients Served" for each state for which this is the case.

HIV positive, AIDS status unknown

1 Individuals who had an insurance (i.e., Medicare Part D, Medicaid, private insurance) payment (premium, co-payment/co-insurance, and/or deductible) paid on their behalf using ADAP funds, either fully or in part.2 This includes clients who enrolled in an insurance plan mid-year and those who were enrolled in an insurance plan that did not cover one or more medically necessary medications such that the ADAP’s full-pay prescription program did instead.


HIV positive, not-AIDS


Only

ADAP-Funded Insurance Only

1

All Clients Served

Full-Pay Medications and ADAP-Funded

Insurance 2


Only


Only

52

-- 100% -- -- -- 0% -- -- -- 0%-- 0% -- -- -- 0% -- -- -- 100%-- -- -- -- -- -- -- -- -- --

0% -- 8% 26% 0% -- 1% 0.2% 0% --0% -- 12% 5% 0% -- 0.1% 0% 0% --0% -- 17% 19% 0% -- 1% 0.4% 0% --0% -- 7% 34% 0% -- 0.5% 2% 0% ---- 5% -- -- -- 36% -- -- -- 0%-- 0% -- -- -- 69% -- -- -- 0%-- 100% -- -- -- 0% -- -- -- 0%-- -- -- -- -- -- -- -- -- --

0.01% -- 8% 1% 0% -- 0% 0% 0% --0% -- 28% 0.5% 0.02% -- 3% 0.4% 0% ---- -- -- -- -- -- -- -- -- --

0% -- 8% 35% 0% -- 0% 0% 0% ---- 0% -- -- -- 36% -- -- -- 0%

0.3% -- 14% 2% 2% -- 0% 0% 0% ---- 0% -- -- -- 45% -- -- -- 0%-- 4% -- -- -- 45% -- -- -- 0%

0% -- 9% 36% 0% -- 0% 0.1% 0% ---- -- -- -- -- -- -- -- -- ---- 7% -- -- -- 51% -- -- -- 0%

0% -- 0.3% 35% 0.3% -- 0% 0% 0% ---- -- -- -- -- -- -- -- -- --

0% -- 11% 21% 0% -- 0% 0% 0% --0% -- 0.4% 45% 0.03% -- 0.03% 1% 0% ---- 35% -- -- -- 22% -- -- -- 1%-- 100% -- -- -- 0% -- -- -- 0%-- -- -- -- -- -- -- -- -- --

8% -- 6% 12% 8% -- 0.2% 0.1% 0.04% ---- 1% -- -- -- 52% -- -- -- 1%-- 100% -- -- -- 0% -- -- -- 0%-- 0% -- -- -- 0% -- -- -- 100%-- 3% -- -- -- 46% -- -- -- 0%-- 100% -- -- -- 0% -- -- -- 0%

0% -- 1% 57% 0% -- 0.5% 0.2% 0% ---- 35% -- -- -- 37% -- -- -- 0%

0% -- 28% 7% 0.1% -- 0% 0% 0% --0% -- 10% 33% 0% -- 0% 0% 0% ---- -- -- -- -- -- -- -- -- --

0% -- 15% 15% 0% -- 0.1% 0.1% 2% ---- 0% -- -- -- 36% -- -- -- 12%

0.1% -- 0.04% 55% 0% -- 0% 1% 0% --4% -- 0% 0% 0% -- 42% 18% 6% ---- 100% -- -- -- 0% -- -- -- 0%-- -- -- -- -- -- -- -- -- ---- -- -- -- -- -- -- -- -- --

0% -- 24% 15% 0% -- 3% 2% 0% ---- 1% -- -- -- 14% -- -- -- 0%-- 0.3% -- -- -- 39% -- -- -- 0.02%-- 0% -- -- -- 0% -- -- -- 100%

0% -- 17% 13% 0.2% -- 0.2% 0% 0% ---- -- -- -- -- -- -- -- -- ---- -- -- -- -- -- -- -- -- --

0.2% -- 12% 24% 3% -- 0.05% 0% 0% ---- 34% -- -- -- 60% -- -- -- 0%-- 1% -- -- -- 43% -- -- -- 0%-- 0% -- -- -- 58% -- -- -- 0%-- -- -- -- -- -- -- -- -- --

14% 15% 13% 21% 14% 10% 3% 2% 11% 9%

Table 12: ADAP Clients Served, by HIV/AIDS Status, June 2014 (continued)

HIV positive, AIDS status unknown (continued)

Full-Pay Medications and ADAP-

Funded

Unknown

All Clients Served


Only

ADAP-Funded

Insurance Only


Funded

All Clients Served


Funded

All Clients Served

CDC-defined AIDS 3


Only

ADAP-Funded

Insurance Only

53

Alabama 1,893 -- -- -- 72% -- -- -- 15%Alaska 95 -- -- -- 0% -- -- -- 0%American Samoa -- -- -- -- -- -- -- -- --Arizona 1,244 5% 13% 0% -- 6% 14% 0% --Arkansas 783 13% 1% 0% -- 13% 1% 0% --California 20,392 4% 3% 0% -- 7% 6% 0% --Colorado 1,763 2% 6% 0% -- 3% 11% 0% --Connecticut 1,433 -- -- -- 11% -- -- -- 14%Delaware 703 -- -- -- 26% -- -- -- 14%District of Columbia 944 -- -- -- 8% -- -- -- 13%Federated States of Micronesia -- -- -- -- -- -- -- -- --Florida 13,187 8% 1% 0% -- 12% 2% 0% --Georgia 5,902 10% 0.1% 0% -- 17% 0.2% 0% --Guam -- -- -- -- -- -- -- -- --Hawaii 226 0% 4% 0% -- 4% 22% 0% --Idaho 137 -- -- -- 7% -- -- -- 15%Illinois 5,003 8% 1% 1% -- 13% 1% 1% --Indiana 2,566 -- -- -- 14% -- -- -- 12%Iowa 253 -- -- -- 5% -- -- -- 12%Kansas 689 4% 13% 0% -- 4% 10% 0% --Kentucky -- -- -- -- -- -- -- -- --Louisiana 2,811 -- -- -- -- -- -- -- 0%Maine 386 0.3% 8% 0% -- 1% 15% 0.3% --Marshall Islands -- -- -- -- -- -- -- -- --Maryland 3,374 4% 5% 0% -- 6% 9% 0% --Massachusetts 3,703 1% 6% 0% -- 1% 12% 0% --Michigan 2,419 -- -- -- 6% -- -- -- 8%Minnesota 533 -- -- -- 10% -- -- -- 14%Mississippi -- -- -- -- -- -- -- -- --Missouri 2,497 3% 6% 4% -- 4% 8% 5% --Montana 119 -- -- -- 4% -- -- -- 15%Nebraska 387 -- -- -- 0% -- -- -- 0%Nevada 671 -- -- -- 0% -- -- -- 0%New Hampshire 285 -- -- -- 6% -- -- -- 14%New Jersey 3,489 -- -- -- 0% -- -- -- 100%New Mexico 406 1% 9% 0% -- 0% 15% 0% --New York 17,114 -- -- -- 7% -- -- -- 12%North Carolina 5,033 9% 1% 0.02% -- 12% 2% 0.04% --North Dakota 82 2% 5% 0% -- 2% 9% 0% --Northern Mariana Islands -- -- -- -- -- -- -- -- --Ohio 1,928 6% 4% 1% -- 7% 6% 1% --Oklahoma 1,143 -- -- -- 10% -- -- -- 12%Oregon 2,785 0.04% 6% 0% -- 0% 12% 0% --Pennsylvania 5,085 4% 2% 1% -- 7% 4% 1% --Puerto Rico 6,947 -- -- -- 0% -- -- -- 0%Republic of Palau -- -- -- -- -- -- -- -- --Rhode Island -- -- -- -- -- -- -- -- --South Carolina 3,488 7% 2% 0% -- 10% 5% 0.1% --South Dakota 165 -- -- -- 16% -- -- -- 13%Tennessee 4,917 -- -- -- 0% -- -- -- 0%Texas 12,213 -- -- -- 0% -- -- -- 0%Utah 458 4% 2% 0% -- 4% 4% 0.2% --Vermont -- -- -- -- -- -- -- -- --Virgin Islands (U.S.) -- -- -- -- -- -- -- -- --Virginia 4,115 5% 5% 1% -- 5% 8% 1% --Washington 2,163 -- -- -- 7% -- -- -- 14%West Virginia 274 -- -- -- 8% -- -- -- 35%Wisconsin 669 -- -- -- 6% -- -- -- 13%Wyoming -- -- -- -- -- -- -- -- --Total 146,872 5% 4% 7% 3% 8% 7% 10% 5%

Table 13: ADAP Clients by CD4 Count, Enrolled During 12-Month Period, June 2014

1 Reported using the most recent CD4 count recorded as of June 30, 2014 for each client who was served by the ADAP program in June 2014. If a client did not receive a CD4 count during June 2014, was reported based on the last CD4 count recorded for that individual prior to June 30, 2014.2 Individuals who had an insurance (i.e., Medicare Part D, Medicaid, private insurance) payment (premium, co-payment/co-insurance, and/or deductible) paid on their behalf using ADAP funds, either fully or in part.3 This includes clients who enrolled in an insurance plan mid-year and those who were enrolled in an insurance plan that did not cover one or more medically necessary medications such that the ADAP’s full-pay prescription program did instead.

Note: 47 ADAPs reported data. American Samoa, Federated States of Micronesia, Kentucky, Marshall Islands, Mississippi, Northern Mariana Islands, Republic of Palau, Rhode Island, Vermont, Virgin Islands (U.S.) and Wyoming did not respond. Data reflect clients enrolled in ADAPs over the past 12 months or the most recent 12 months for which data are available. A dash (--) indicates the ADAP did not report data. A zero (0%) indicates the ADAP responded zero (0%) to the question. In some cases, an ADAP was able to report data though was unable to distinguish between clients served by the full-pay medications program only, the ADAP-funded insurance program only, and the full-pay medications and ADAP-funded insurance programs.

Note: Many ADAPs were unable to report CD4 Count separately for: clients served by a full-pay prescription program only; clients served by an ADAP-funded insurance program only; and clients served by a fully-pay prescription program and ADAP-funded insurance program. As such, the percentage of clients that fall into each CD4 Count category are reported under "All Clients Served" for each state for which this is the case.



Only

ADAP-Funded

Insurance Only 2


Funded Insurance 3

CD4 ≤200

All Clients Served


Only




All Clients Served

CD4 between 201-350

54

-- -- -- 9% -- -- -- 3% -- -- -- 1%-- -- -- 0% -- -- -- 0% -- -- -- 100%-- -- -- -- -- -- -- -- -- -- -- --

4% 10% 0% -- 15% 33% 0% -- 0% 0% 0% --54% 10% 0% -- 6% 3% 0% -- 0% 0% 0% --10% 9% 0% -- 29% 27% 0% -- 2% 2% 0% --5% 18% 0.1% -- 6% 46% 0.1% -- 0.4% 2% 0% ---- -- -- 19% -- -- -- 57% -- -- -- 0%-- -- -- 15% -- -- -- 45% -- -- -- 0%-- -- -- 17% -- -- -- 47% -- -- -- 16%-- -- -- -- -- -- -- -- -- -- -- --

17% 3% 0% -- 48% 9% 0.01% -- 0% 0% 0% --21% 0.2% 0.1% -- 43% 1% 0.1% -- 7% 1% 0% --

-- -- -- -- -- -- -- -- -- -- -- --5% 17% 0% -- 21% 22% 0.4% -- 0% 4% 0% ---- -- -- 19% -- -- -- 60% -- -- -- 0%

18% 2% 2% -- 45% 5% 6% -- 0% 0% 0% ---- -- -- 16% -- -- -- 42% -- -- -- 16%-- -- -- 19% -- -- -- 59% -- -- -- 4%

3% 18% 0% -- 9% 38% 0% -- 0% 0.4% 0% ---- -- -- -- -- -- -- -- -- -- -- ---- -- -- 0% -- -- -- 0% -- -- -- 100%

1% 18% 0% -- 2% 52% 1% -- 0% 2% 1% ---- -- -- -- -- -- -- -- -- -- -- --

7% 12% 0% -- 19% 37% 0% -- 0.2% 0.1% 0% --1% 18% 0.03% -- 1% 61% 0.03% -- 0.1% 0.03% 0% ---- -- -- 12% -- -- -- 35% -- -- -- 39%-- -- -- 18% -- -- -- 57% -- -- -- 0%-- -- -- -- -- -- -- -- -- -- -- --

5% 11% 5% -- 7% 24% 16% -- 1% 1% 1% ---- -- -- 18% -- -- -- 50% -- -- -- 13%-- -- -- 0% -- -- -- 0% -- -- -- 100%-- -- -- 0% -- -- -- 0% -- -- -- 100%-- -- -- 18% -- -- -- 54% -- -- -- 8%-- -- -- 0% -- -- -- 0% -- -- -- 0%

0.2% 17% 0% -- 1% 57% 0% -- 0.5% 0% 0% ---- -- -- 18% -- -- -- 61% -- -- -- 2%

18% 3% 0.02% -- 49% 7% 0.04% -- 0.3% 0.1% 0% --2% 15% 0% -- 11% 38% 0% -- 5% 11% 0% ---- -- -- -- -- -- -- -- -- -- -- --

10% 9% 1% -- 23% 29% 3% -- 0% 0% 0% ---- -- -- 17% -- -- -- 43% -- -- -- 18%

0% 19% 0% -- 0.04% 57% 0% -- 0.04% 5% 0% --10% 6% 2% -- 34% 18% 6% -- 4% 1% 0.3% --

-- -- -- 0% -- -- -- 0% -- -- -- 100%-- -- -- -- -- -- -- -- -- -- -- ---- -- -- -- -- -- -- -- -- -- -- --

11% 6% 0.03% -- 35% 22% 0.03% -- 1% 0.5% 0% ---- -- -- 22% -- -- -- 48% -- -- -- 0%-- -- -- 0% -- -- -- 0% -- -- -- 100%-- -- -- 0% -- -- -- 0% -- -- -- 100%

8% 8% 0.4% -- 22% 28% 1% -- 12% 7% 0.2% ---- -- -- -- -- -- -- -- -- -- -- ---- -- -- -- -- -- -- -- -- -- -- --

6% 12% 2% -- 14% 36% 4% -- 0.5% 1% 0.05% ---- -- -- 22% -- -- -- 56% -- -- -- 1%-- -- -- 25% -- -- -- 32% -- -- -- 0%-- -- -- 19% -- -- -- 62% -- -- -- 0.4%-- -- -- -- -- -- -- -- -- -- -- --

11% 11% 14% 4% 29% 32% 41% 12% 44% 1% 1% 21%


Only

ADAP-Funded

Insurance Only


Funded Insurance

All Clients Served

Table 13: ADAP Clients by CD4 Count, Enrolled During 12-Month Period, June 2014 (continued)

UnknownCD4 > 500



Funded Insurance

All Clients Served

CD4 between 351-500


Only


Only

ADAP-Funded

Insurance Only


Funded Insurance

All Clients Served

55

Alabama 1,893 -- -- -- 83% -- -- -- 16% -- -- -- 2%Alaska 95 -- -- -- 0% -- -- -- 0% -- -- -- 100%American Samoa -- -- -- -- -- -- -- -- -- -- -- -- --Arizona 1,244 17% 48% 0% -- 13% 22% 0% -- 0.1% 0% 0% --Arkansas 783 77% 11% 0% -- 9% 2% 0% -- 0% 0% 0% --California 20,392 42% 41% 0% -- 10% 4% 0% -- 1% 1% 0% --Colorado 1,763 0% 0% 0% -- 0% 0% 0% -- 17% 83% 0.1% --Connecticut 1,433 -- -- -- 90% -- -- -- 10% -- -- -- 0%Delaware 703 -- -- -- 66% -- -- -- 34% -- -- -- 0%District of Columbia 944 -- -- -- 72% -- -- -- 13% -- -- -- 16%Federated States of Micronesia -- -- -- -- -- -- -- -- -- -- -- -- --Florida 13,187 74% 14% 0.01% -- 12% 1% 0% -- 0% 0% 0% --Georgia 5,902 35% 0.1% 0.1% -- 13% 0.1% 0.1% -- 49% 2% 0% --Guam -- -- -- -- -- -- -- -- -- -- -- -- --Hawaii 226 21% 62% 0.4% -- 4% 4% 0% -- 4% 4% 0% --Idaho 137 -- -- -- 96% -- -- -- 4% -- -- -- 0%Illinois 5,003 74% 8% 9% -- 8% 1% 1% -- 0% 0% 0% --Indiana 2,566 -- -- -- 42% -- -- -- 18% -- -- -- 40%Iowa 253 -- -- -- 93% -- -- -- 4% -- -- -- 3%Kansas 689 17% 71% 0% -- 3% 9% 0% -- 0.1% 0.4% 0% --Kentucky -- -- -- -- -- -- -- -- -- -- -- -- --Louisiana 2,811 -- -- -- 0% -- -- -- 0% -- -- -- 100%Maine 386 3% 83% 1% -- 1% 8% 0% -- 1% 4% 1% --Marshall Islands -- -- -- -- -- -- -- -- -- -- -- -- --Maryland 3,374 29% 56% 0% -- 7% 7% 0% -- 0.1% 0.1% 0% --Massachusetts 3,703 2% 88% 0.1% -- 1% 9% 0% -- 0.1% 0.03% 0% --Michigan 2,419 -- -- -- 51% -- -- -- 9% -- -- -- 40%Minnesota 533 -- -- -- 75% -- -- -- 12% -- -- -- 13%Mississippi -- -- -- -- -- -- -- -- -- -- -- -- --Missouri 2,497 14% 42% 27% -- 4% 6% 4% -- 1% 1% 1% --Montana 119 -- -- -- 81% -- -- -- 7% -- -- -- 13%Nebraska 387 -- -- -- 0% -- -- -- 0% -- -- -- 100%Nevada 671 -- -- -- 0% -- -- -- 0% -- -- -- 100%New Hampshire 285 -- -- -- 84% -- -- -- 8% -- -- -- 8%New Jersey 3,489 -- -- -- 72% -- -- -- 28% -- -- -- 0%New Mexico 406 0.5% 79% 0% -- 1% 19% 0% -- 0.5% 0% 0% --New York 17,114 -- -- -- 85% -- -- -- 12% -- -- -- 3%North Carolina 5,033 71% 11% 0.1% -- 16% 1% 0.02% -- 0.3% 0.1% 0% --North Dakota 82 16% 61% 0% -- 4% 9% 0% -- 4% 7% 0% --Northern Mariana Islands -- -- -- -- -- -- -- -- -- -- -- -- --Ohio 1,928 36% 44% 5% -- 10% 5% 1% -- 0% 0% 0% --Oklahoma 1,143 -- -- -- 52% -- -- -- 34% -- -- -- 14%Oregon 2,785 0.04% 89% 0.1% -- 0.04% 11% 0% -- 0.04% 0% 0% --Pennsylvania 5,085 38% 22% 7% -- 7% 3% 1% -- 13% 6% 2% --Puerto Rico 6,947 -- -- -- 0% -- -- -- 0% -- -- -- 100%Republic of Palau -- -- -- -- -- -- -- -- -- -- -- -- --Rhode Island -- -- -- -- -- -- -- -- -- -- -- -- --South Carolina 3,488 50% 32% 0.1% -- 11% 3% 0% -- 2% 1% 0% --South Dakota 165 -- -- -- 84% -- -- -- 15% -- -- -- 1%Tennessee 4,917 -- -- -- 0% -- -- -- 0% -- -- -- 100%Texas 12,213 -- -- -- 0% -- -- -- 0% -- -- -- 100%Utah 458 27% 31% 1% -- 4% 3% 0.4% -- 19% 15% 0.4% --Vermont -- -- -- -- -- -- -- -- -- -- -- -- --Virgin Islands (U.S.) -- -- -- -- -- -- -- -- -- -- -- -- --Virginia 4,115 20% 46% 5% -- 8% 11% 2% -- 2% 5% 0.3% --Washington 2,163 -- -- -- 93% -- -- -- 6% -- -- -- 1%West Virginia 274 -- -- -- 77% -- -- -- 23% -- -- -- 0%Wisconsin 669 -- -- -- 90% -- -- -- 9% -- -- -- 0.4%Wyoming -- -- -- -- -- -- -- -- -- -- -- -- --Total 146,872 24% 18% 1% 19% 5% 2% 0.2% 4% 3% 2% 0.1% 21%


Table 14: ADAP Clients by Viral Load, Enrolled During 12-Month Period, June 2014


Only




All Clients Served


Note: Many ADAPs were unable to report Viral Load separately for: clients served by a full-pay prescription program only; clients served by an ADAP-funded insurance program only; and clients served by a fully-pay prescription program and ADAP-funded insurance program. As such, the percentage of clients that fall into each Viral Load category are reported under "All Clients Served" for each state for which this is the case.


Viral Load ≤200 Viral Load >200 Unknown


Only

ADAP-Funded

Insurance Only 2

1 Reported using the most recent viral load recorded for each client as of June 30, 2014 among those served by the ADAP program in June 2014 (including those clients on ARVs and those clients not on ARVs). If a client did not receive a viral load during June 2014, reported based on the last viral load recorded for that individual prior to June 30, 2014.

Note: 47 ADAPs reported data. American Samoa, Federated States of Micronesia, Kentucky, Marshall Islands, Mississippi, Northern Mariana Islands, Republic of Palau, Rhode Island, Vermont, Virgin Islands (U.S.) and Wyoming did not respond. Data reflect clients enrolled in ADAPs over the past 12 months or the most recent 12 months for which data are available. A dash (--) indicates the ADAP did not report data. A zero (0%) indicates the ADAP responded zero (0%) to the question. In some cases, an ADAP was able to report data


Only

ADAP-Funded

Insurance Only


Funded Insurance

All Clients Served


Funded Insurance 3

All Clients Served

56

State/Territory

Intake at Local ASOs, CBOs, and Local Health

Department 1 (ADAP Funds Not Used)

Intake at Local ASOs, CBOs, and Local Health

Department (ADAP Funds Used All or In Part)

Intake at ADAP Office

Intake at Private Clinical Settings Online Application Application Over

the Phone Faxed Application Mailed Application Other State Programs

Other Enrollment Processes

Alabama Yes No No Yes No No Yes Yes No NoAlaska Yes Yes Yes No No Yes Yes Yes No NoAmerican Samoa -- -- -- -- -- -- -- -- -- --Arizona Yes Yes Yes No No No Yes Yes No YesArkansas Yes No No No No Yes Yes Yes No NoCalifornia Yes Yes No No No No No No No YesColorado No Yes Yes Yes No No Yes Yes No NoConnecticut No No Yes No No No Yes Yes No NoDelaware Yes No No No No No No No No NoDistrict of Columbia Yes No Yes No No No Yes Yes No NoFederated States of Micronesia -- -- -- -- -- -- -- -- -- --Florida No Yes Yes No No No No No No NoGeorgia Yes No No No Yes No No Yes No NoGuam -- -- -- -- -- -- -- -- -- --Hawaii Yes No No Yes No No No No No NoIdaho Yes No No No No No No No No YesIllinois Yes No No No Yes No Yes Yes No NoIndiana Yes No No No No No No No No NoIowa No Yes No No No No No No No NoKansas Yes No No No No No No No No NoKentucky -- -- -- -- -- -- -- -- -- --Louisiana Yes No Yes Yes No Yes Yes Yes No NoMaine Yes No Yes Yes No No Yes Yes No NoMarshall Islands -- -- -- -- -- -- -- -- -- --Maryland Yes No Yes Yes No No Yes Yes No NoMassachusetts Yes No Yes Yes No No Yes Yes No NoMichigan Yes No No Yes No No Yes Yes No NoMinnesota No Yes No Yes Yes No Yes Yes No NoMississippi -- -- -- -- -- -- -- -- -- --Missouri No Yes No Yes No No No No No NoMontana Yes No No Yes No No No Yes No NoNebraska Yes No Yes Yes No No Yes Yes No NoNevada No Yes No No No Yes No Yes No YesNew Hampshire Yes Yes No Yes No No Yes Yes No NoNew Jersey Yes No Yes Yes No No Yes Yes No NoNew Mexico No Yes No No No No No No No NoNew York No No No No No No Yes Yes No NoNorth Carolina Yes No No Yes No No No Yes No NoNorth Dakota Yes No No No No No No No No NoNorthern Mariana Islands -- -- -- -- -- -- -- -- -- --Ohio No No Yes No No No No No No NoOklahoma No No No No Yes No No No No YesOregon No No Yes No No No Yes Yes No NoPennsylvania No No No No No No Yes Yes No NoPuerto Rico Yes No No No No No Yes Yes No NoRepublic of Palau -- -- -- -- -- -- -- -- -- --Rhode Island -- -- -- -- -- -- -- -- -- --South Carolina Yes No No Yes No No Yes Yes Yes YesSouth Dakota No No Yes No No No No No No NoTennessee Yes No No No No No No No No NoTexas Yes No No No No No Yes Yes No NoUtah No Yes No Yes No No Yes Yes No NoVermont -- -- -- -- -- -- -- -- -- --Virgin Islands (U.S.) -- -- -- -- -- -- -- -- -- --Virginia Yes No Yes Yes No Yes Yes Yes No NoWashington No No No No No No Yes Yes No NoWest Virginia Yes No Yes Yes No Yes Yes Yes No NoWisconsin Yes No Yes Yes No No Yes Yes No NoWyoming No No No No No No No No No YesTotal 31 12 18 20 4 6 28 32 1 71 ASOs=AIDS Service Organizations; CBOs=Community-Based Organizations.

Note: 48 ADAPs reported data. American Samoa, Federated States of Micronesia, Kentucky, Marshall Islands, Mississippi, Northern Mariana Islands, Republic of Palau, Rhode Island, Vermont and Virgin Islands (U.S.) did not respond. A dash (--) indicates the ADAP did not report data.

Table 15: ADAP Client Enrollment Processes, as of June 30, 2014

57


ADAP-Funded Insurance Program Gross Income Modified Adjusted Gross

Income (MAGI) Net Income Individual Income

Household Income Family Income

Alabama 250% FPL 250% FPL Yes No No Yes Yes No NoAlaska 300% FPL 300% FPL Yes No No Yes No Yes YesAmerican Samoa -- -- -- -- -- -- -- -- --Arizona 300% FPL 300% FPL No Yes No No No No YesArkansas 400% FPL 400% FPL Yes No No No No No YesCalifornia 500% FPL 500% FPL Yes No No Yes No No YesColorado 500% FPL 400% FPL No Yes No No No No YesConnecticut 400% FPL 400% FPL No No Yes No Yes No YesDelaware 500% FPL 500% FPL No Yes No No Yes No YesDistrict of Columbia 500% FPL 500% FPL Yes No No Yes No No YesFederated States of Micronesia -- -- -- -- -- -- -- -- --Florida 400% FPL 400% FPL Yes No No No No No NoGeorgia 300% FPL 300% FPL Yes Yes No No No No NoGuam -- -- -- -- -- -- -- -- --Hawaii 400% FPL 400% FPL Yes No No No No No YesIdaho 200% FPL NA Yes No No Yes No Yes NoIllinois 300% FPL 450% FPL No Yes No No Yes No YesIndiana 300% FPL 300% FPL No Yes No No No No YesIowa 200% FPL 400% FPL Yes No 3 No No No No YesKansas 300% FPL 300% FPL Yes No No Yes Yes Yes YesKentucky -- -- -- -- -- -- -- -- --Louisiana 300% FPL 300% FPL Yes No No No No No NoMaine 500% FPL 500% FPL Yes No No Yes No Yes YesMarshall Islands -- -- -- -- -- -- -- -- --Maryland 500% FPL 500% FPL Yes No No No Yes No YesMassachusetts 500% FPL 4 500% FPL 4 Yes No No Yes No No NoMichigan 450% FPL 400% FPL Yes Yes No No Yes No NoMinnesota 300% FPL 300% FPL No Yes No No No No YesMississippi -- -- -- -- -- -- -- -- --Missouri 300% FPL 300% FPL Yes No No No No Yes NoMontana 430% FPL 430% FPL Yes No No No No Yes NoNebraska 200% FPL 200% FPL Yes No No Yes No No NoNevada 400% FPL 400% FPL Yes No No No No Yes YesNew Hampshire 400% FPL 400% FPL Yes No No No Yes No YesNew Jersey 500% FPL 500% FPL Yes No No No No No YesNew Mexico 400% FPL 400% FPL Yes No No No No No YesNew York 435% FPL 435% FPL Yes No No No No No YesNorth Carolina 300% FPL 300% FPL Yes No No No No No YesNorth Dakota 300% FPL 300% FPL Yes No No No Yes No NoNorthern Mariana Islands -- -- -- -- -- -- -- -- --Ohio 300% FPL 300% FPL Yes No No No No No NoOklahoma 200% FPL 400% FPL Yes Yes No Yes Yes Yes NoOregon 400% FPL 400% FPL Yes No No No No No YesPennsylvania 500% FPL 5 500% FPL 5 Yes No No No Yes No YesPuerto Rico 200% FPL 200% FPL No No Yes No No No NoRepublic of Palau -- -- -- -- -- -- -- -- --Rhode Island -- -- -- -- -- -- -- -- --South Carolina 300% FPL 550% FPL Yes No No No Yes No YesSouth Dakota 300% FPL NA Yes No No No No No NoTennessee 300% FPL 300% FPL Yes Yes No Yes Yes Yes NoTexas 200% FPL 200% FPL Yes No No No No Yes NoUtah 250% FPL 250% FPL Yes No No No Yes No --Vermont -- -- -- -- -- -- -- -- --Virgin Islands (U.S.) -- -- -- -- -- -- -- -- --Virginia 400% FPL 400% FPL Yes No No No No No YesWashington 400% FPL 400% FPL Yes Yes Yes Yes No Yes YesWest Virginia 400% FPL 400% FPL No Yes No No No No NoWisconsin 300% FPL 300% FPL Yes No No No No No NoWyoming 350% FPL 350% FPL Yes No No Yes No No No

Table 16: ADAP Client Financial Eligibility Requirements, as of June 30, 2014

1 “Recognized” defined as legal domestic partnerships/same-sex marriages in each jurisdiction and/or acceptance of legal domestic partnerships/same-sex marriages that were granted outside of the jurisdiction.

Note: 48 ADAPs reported data. American Samoa, Federated States of Micronesia, Kentucky, Marshall Islands, Mississippi, Northern Mariana Islands, Republic of Palau, Rhode Island, Vermont and Virgin Islands (U.S.) did not respond. A dash (--) indicates the ADAP did not report data. The 2014 Federal Poverty Level (FPL) was $11,670 (slightly higher in Alaska and Hawaii) for a household of one.

Financial Eligibility 2 Recognition of Domestic Partnerships/Same-Sex

Marriages 1State/Territory

Calculation Basis

2 In 2014, the ACA expands Medicaid eligibility to most people with income up to 133% of the federal poverty level (FPL). However, in addition to new income counting rules for most Medicaid populations (called “Modified Adjusted Gross Income”), there is an additional 5% disregard of income, effectively bumping the Medicaid income eligibility threshold to 138% FPL.3 Iowa's ADAP will be moving from gross income calculation to modified adjusted gross income (MAGI) calculation for clients beginning in 2014.

5 In Pennsylvania, clients at >500% FPL who have dependents have an allowance for those dependents that account for income over the determined limit.

4 In Massachusetts, the 500% FPL income eligibilty requirement also includes a $5,060 allowance for each dependent.

58











Alabama Yes Yes No No No No Yes Yes No No

Alaska Yes Yes No No No No No No Rx for med on ADAP formulary

Rx for med on ADAP formulary

American Samoa -- -- -- -- -- -- -- -- -- --Arizona Yes Yes No No No No No No No NoArkansas Yes Yes No No No No No No No No

California Yes Yes Current within 6 months of enrollment

Current within 6 months of enrollment


Current within 6 months of enrollment No No No No

Colorado Yes Yes No No No No No No No No

Connecticut Yes Yes Current within 12 months of enrollment



Current within 12 months of enrollment No No No No

Delaware Yes Yes No No No No No No No NoDistrict of Columbia Yes Yes No No No No No No No NoFederated States of Micronesia -- -- -- -- -- -- -- -- -- --

Florida Yes Yes

Most recent laboratory tests obtained during

enrollment or recertification







Yes Yes No No

Georgia Yes Yes No No No No No No No NoGuam -- -- -- -- -- -- -- -- -- --Hawaii Yes Yes No No No No No No No NoIdaho Yes NA No NA No NA No NA No NA

Illinois Yes Yes

Current within 6 months of enrollment unless new

client to the program or out of care for over 12

consecutive months then you have a 90 day

temporary approval to get labs into the program













No No No No

Indiana Yes Yes No No No No No No Physician certification

Physician certification

Iowa Yes Yes No No No No Yes Yes No NoKansas Yes Yes No No No No No No No NoKentucky -- -- -- -- -- -- -- -- -- --

Louisiana Yes Yes No Current within 6 months of enrollment No Current within 6 months of

enrollment No Yes No No

Maine Yes Yes No No No No No No No NoMarshall Islands -- -- -- -- -- -- -- -- -- --

Maryland Yes Yes No No No No No No Physician certification

Physician certification

Massachusetts Yes Yes No No No No No No No NoMichigan Yes Yes Current at enrollment Current at enrollment Current at enrollment Current at enrollment No No No No

Minnesota No No Current within 12 months Current within 12 months Current within 12 months Current within 12 months No No No No

Mississippi -- -- -- -- -- -- -- -- -- --Missouri Yes Yes No No No No No No No NoMontana Yes Yes No No No No No No No NoNebraska Yes Yes No No No No No No No NoNevada Yes Yes No No No No No No No No

New Hampshire Yes Yes Current at enrollment and re-enrollment

Current at enrollment and re-enrollment

Current at enrollment and re-enrollment

Current at enrollment and re-enrollment Yes Yes No No

New Jersey Yes Yes No No No No No No No No

New Mexico Yes Yes Updated annually Updated annually Updated annually Updated annually Yes Yes No

Must be enrolled in Health Services

Provider (HSP, state grantee)

New York Yes Yes No No No No No No No NoNorth Carolina No No No No No No Yes Yes No NoNorth Dakota Yes Yes Current within 6 months Current within 6 months Current within 6 months Current within 6 months Yes Yes No NoNorthern Mariana Islands -- -- -- -- -- -- -- -- -- --Ohio Yes Yes No No No No No No No NoOklahoma Yes Yes No No No No No No No NoOregon Yes Yes No No No No No No No NoPennsylvania Yes Yes No No No No No No No NoPuerto Rico Yes Yes No No No No No No No NoRepublic of Palau -- -- -- -- -- -- -- -- -- --Rhode Island -- -- -- -- -- -- -- -- -- --South Carolina Yes Yes Yes Yes Yes Yes No No No NoSouth Dakota Yes NA Yes NA Yes NA No NA No NATennessee Yes Yes No No No No No No No NoTexas Yes Yes Yes Yes Yes Yes No No No NoUtah Yes Yes No No No No Yes Yes No NoVermont -- -- -- -- -- -- -- -- -- --Virgin Islands (U.S.) -- -- -- -- -- -- -- -- -- --Virginia Yes Yes No No No No No No No NoWashington Yes Yes No No No No No No No NoWest Virginia Yes Yes No No No No No No No NoWisconsin Yes Yes No No No No No No No NoWyoming Yes Yes No No No No No No No No1 CD4=CD4 cell count; VL = Viral load.

Table 17: ADAP Client Medical Eligibility Requirements, as of June 30, 2014


State/Territory

Medical Eligibility 1

Proof of HIV Status CD4 Count Viral Load Prescription for ARV Other

59

Other RequirementFull-Pay Medications

(Uninsured)ADAP-Funded Insurance

ProgramFull-Pay Medications (Uninsured) ADAP-Funded Insurance Program Full-Pay Medications

(Uninsured)ADAP-Funded Insurance

ProgramADAP-Funded Insurance

Program

Alabama No No Proof of state residency required Proof of state residency required Ongoing Ongoing No

Alaska No No Must be a resident for at least 30 days with proof and intent to stay

Must be a resident for at least 30 days with proof and intent to stay Ongoing Ongoing No

American Samoa -- -- -- -- -- -- --

Arizona No No Proof of state residency required Proof of state residency required No Ongoing No

Arkansas No No Proof of state residency required Proof of state residency required Ongoing Ongoing No

California No No Proof of state residency required Proof of state residency required No No Cannot be enrolled in full-scope Medi-Cal

Colorado No No Proof of state residency required Proof of state residency required No No No

Connecticut No No Self-attestation required Self-attestation required No No No

Delaware No No Proof of state residency required Proof of state residency required Ongoing Ongoing No

District of Columbia $25,000 $25,000 Proof of state residency required Proof of state residency required No No No

Federated States of Micronesia -- -- -- -- -- -- --

Florida No No Proof of state residency required Proof of state residency required Initial Initial No

Georgia $10,000 $10,000 Proof of state residency required Proof of state residency required As needed As needed No

Guam -- -- -- -- -- -- --

Hawaii No No Proof of state residency required 1 Proof of state residency required 1 Ongoing Ongoing No

Idaho No No Proof of state residency required N/A Ongoing No Yes

Illinois No No Proof of state residency required Proof of state residency required No No No

Indiana No No Proof of state residency required Proof of state residency required Ongoing Ongoing No

Iowa No No Proof of state residency required Proof of state residency required Ongoing Ongoing No

Kansas No No Proof of state residency required Proof of state residency required Ongoing Ongoing No

Kentucky -- -- -- -- -- -- --

Louisiana No No Proof of state residency required Proof of state residency required No No No

Maine No No Proof of state residency required Proof of state residency required No No No

Marshall Islands -- -- -- -- -- -- --

Maryland No No Proof of state residency required Proof of state residency required No No Yes

Massachusetts No No Proof of state residency required Proof of state residency required No No No

Michigan No No Self-attestation required Self-attestation required No No YesMinnesota No No Self-attestation required Self-attestation required No No NoMississippi -- -- -- -- -- -- --

Missouri No No Proof of state residency required Proof of state residency required Ongoing Ongoing No

Montana No No Self-attestation required Self-attestation required Initial Initial NoNebraska No No Self-attestation required Self-attestation required As needed As needed No

Nevada $10,000 in liquid assets with specific exlcusions

$10,000 in liquid assets with specific exlcusions

Proof of state residency required Self-attestation required As needed As needed No

New Hampshire No No Proof of state residency required Proof of state residency required Ongoing Ongoing No

New Jersey No No Self-attestation required Self-attestation required No No No

New Mexico $9,999 in checking and savings

$9,999 in checking and savings

Self-attestation required Self-attestation required Initial Ongoing No

New York

$25,000 in liquid assets, excluding federally

recognized retirement account

$25,000 in liquid assets, excluding federally

recognized retirement account

Proof of state residency required Proof of state residency required No No No

North Carolina No No Proof of state residency required Proof of state residency required No No No

North Dakota No No Proof of state residency required Proof of state residency required Ongoing Ongoing No

Northern Mariana Islands -- -- -- -- -- -- --

Ohio No No Proof of state residency required Proof of state residency required As needed As needed No

Oklahoma No No Proof of state residency required Proof of state residency required Ongoing Ongoing No

Oregon No No Proof of state residency required Proof of state residency required No No No

Pennsylvania No No Proof of state residency required Proof of state residency required No No No

Puerto Rico No No Must be a resident for at least 60 days with proof

Must be a resident for at least 60 days with proof

Ongoing Ongoing No

Republic of Palau -- -- -- -- -- -- --Rhode Island -- -- -- -- -- -- --South Carolina No $10,000 Self-attestation required Self-attestation required As needed As needed No

South Dakota No N/A Proof of state residency required N/A Ongoing N/A No

Tennessee $8,000 $8,000 Proof of state residency required Proof of state residency required Ongoing Ongoing No

Texas No No Proof of state residency required Proof of state residency required No No No

Utah $5,000 $5,000 Proof of state residency required Proof of state residency required As needed As needed No

Vermont -- -- -- -- -- -- --Virgin Islands (U.S.) -- -- -- -- -- -- --

Virginia No No Proof of state residency required Proof of state residency required No No No

Washington No No Proof of state residency required Proof of state residency required No No No

West Virginia No No Proof of state residency required Proof of state residency required Ongoing Ongoing No

Wisconsin No No Proof of state residency required Proof of state residency required No No No

Wyoming No No Proof of state residency required Proof of state residency required Ongoing Ongoing No

Total 7 9 48 46 48 48 48

Table 18: ADAP Client Eligibility Requirements, as of June 30, 2014


State/TerritoryAsset Limits State Residency Requirement Case Management Requirement

1 With provisions for individuals who are physically present and live in the state but lack any documentation to that effect, such as homeless persons.

60

State/Territory Purchasing Mechanism Participates in 340B Drug Discount Program

Participates in HRSA Prime Vendor Program

Average Dispensing Fee Per Prescription 1

Alabama Dual Yes Yes $6.95Alaska Direct purchase Yes Yes $25American Samoa -- -- -- --Arizona Dual Yes Yes $10Arkansas Dual Yes Yes $5California Rebate Yes No $4Colorado Dual Yes Yes $6Connecticut Rebate Yes No $2Delaware Hybrid Yes Yes $3District of Columbia Direct purchase No No $11Federated States of Micronesia -- -- -- --Florida Dual Yes Yes $0Georgia Dual Yes No $12Guam -- -- -- --Hawaii Dual Yes Yes $13.50 2

Idaho Rebate Yes No $0Illinois Dual Yes Yes $13Indiana Rebate Yes No $2Iowa Dual Yes Yes $11Kansas Rebate Yes No $3Kentucky -- -- -- --Louisiana Dual Yes Yes $0Maine Rebate Yes No $3Marshall Islands -- -- -- --Maryland Rebate Yes No $3Massachusetts Rebate Yes No $3.40Michigan Rebate Yes Yes $7Minnesota Rebate Yes No $0Mississippi Direct purchase Yes -- --Missouri Rebate Yes Yes $2Montana Dual Yes Yes $6Nebraska Dual Yes No $2Nevada Hybrid Yes No $19New Hampshire Rebate Yes No $2New Jersey Rebate Yes No $4New Mexico Direct purchase Yes Yes $1New York Rebate Yes No $3.50North Carolina Dual Yes Yes $14North Dakota Rebate Yes No $5Northern Mariana Islands -- -- -- --Ohio Hybrid Yes Yes $13Oklahoma Dual Yes Yes $6Oregon Dual Yes Yes $25Pennsylvania Rebate Yes Yes $4Puerto Rico Dual Yes Yes $3Republic of Palau -- -- -- --Rhode Island Rebate Yes -- --South Carolina Dual Yes Yes $14South Dakota Rebate Yes No $5Tennessee Direct purchase Yes Yes $15Texas Hybrid Yes Yes $0Utah Dual Yes No $20Vermont Rebate Yes -- --Virgin Islands (U.S.) -- -- -- --Virginia Dual Yes Yes $0Washington Rebate Yes No $5West Virginia Rebate Yes No $2.50Wisconsin Rebate Yes No $4Wyoming Rebate Yes No $5Total 50 25

Table 19: ADAP Drug Purchasing, June 2014

HRSA Prime Vendor Program – Participants in the 340B Program may also participate in the 340B Prime Vendor Program. A “prime vendor” is an entity that negotiates with manufacturers on behalf of a group of drug purchasers, in order to obtain reduced drug prices. HRSA has chosen a prime vendor to negotiate additional discounts (i.e., lower than the 340B ceiling price or sub-340B ceiling price) for participants, including ADAPs.


Direct Purchase states – ADAPs using this model centrally purchase and dispense medications through their own pharmacy or a single contract pharmacy service provider.

Rebate states – These are ADAPs who pay retail pharmacies a pre-determined amount at the point of sale for drugs dispensed to ADAP clients. ADAP then bills drug manufacturers for the 340b Unit Rebate amount for the number of units dispensed.

Hybrid states – A direct purchase state that utilizes an existing entity (e.g., University Hospital) to purchase and distribute ADAP drugs. The entity maintains a single drug inventory purchased at 340B prices. To secure the additional supplemental discounts negotiated by the ADAP Crisis Task Force, these ADAPs must submit rebate claims for the supplemental discount amount.

Dual Purchaser – ADAPs that purchase and dispense medications through their own pharmacy or a single contract pharmacy service provider AND pay retail pharmacies for some clients and file rebate claims including partial pay claims.

340B Drug Pricing Program – requires drug manufacturers to provide outpatient drugs to eligible health care organizations for eligible patients at significantly reduced prices. The 340B program is designed to provide a pricing benefit to safety-net providers. The 340B program is administered by the Office of Pharmacy Affairs.

2 The prescription dispensing fee in Hawaii (of $13.50) is paid for those medications purchased for full-pay prescription clients only.

1 Note: States may pay a different dispensing fee for generic vs. brand name medications.

61

State/Territory June 2014 Drug Purchases

Drug Purchases % of Total

Expenditures

June 2014 Co-Payment

Expenditures

Co-Payment % of Total Expenditures

June 2014 Total Drug Expenditures

(Including Purchases and Co-payments)

Alabama $1,401,102 100% $0 0% $1,401,102Alaska $93,018 100% $0 0% $93,018American Samoa -- -- -- -- --Arizona $377,594 58% $276,415 42% $654,009Arkansas $310,335 100% $0 0% $310,335California $28,494,106 100% $0 0% $28,494,106Colorado $391,166 59% $273,786 41% $664,952Connecticut $1,746,698 89% $217,496 11% $1,964,194Delaware $82,164 100% $0 0% $82,164District of Columbia $904,798 97% $27,232 3% $932,030Federated States of Micronesia -- -- -- -- --Florida $18,345,026 97% $616,335 3% $18,961,361Georgia $4,558,356 100% $0 0% $4,558,356Guam -- -- -- -- --Hawaii $89,209 78% $25,620 22% $114,829Idaho $239,686 100% $0 0% $239,686Illinois $2,898,838 89% $347,929 11% $3,246,767Indiana $578,932 96% $27,176 4% $606,108Iowa $39,445 59% $27,477 41% $66,922Kansas $241,215 30% $573,992 70% $815,207Kentucky -- -- -- -- --Louisiana $2,161,730 90% $243,325 10% $2,405,055Maine $40,984 59% $28,180 41% $69,164Marshall Islands -- -- -- -- --Maryland $2,428,981 82% $538,047 18% $2,967,028Massachusetts $252,759 60% $171,881 40% $424,640Michigan $2,884,729 100% $0 0% $2,884,729Minnesota $417,888 100% $0 0% $417,888Mississippi -- -- -- -- --Missouri $1,446,374 65% $775,189 35% $2,221,563Montana $77,184 54% $64,636 46% $141,820Nebraska $239,512 100% $0 0% $239,512Nevada $428,630 86% $72,213 14% $500,843New Hampshire $220,905 89% $28,586 11% $249,491New Jersey $5,104,516 71% $2,083,723 29% $7,188,239New Mexico $75,098 100% $0 0% $75,098New York $27,006,223 100% $0 0% $27,006,223North Carolina $3,791,311 97% $115,625 3% $3,906,936North Dakota $0 0% $51,881 100% $51,881Northern Mariana Islands -- -- -- -- --Ohio $777,282 53% $689,780 47% $1,467,062Oklahoma $79,725 38% $131,889 62% $211,614Oregon $1,129,918 100% $0 0% $1,129,918Pennsylvania $8,125,647 95% $449,444 5% $8,575,091Puerto Rico $15,679,326 98% $289,833 2% $15,969,159Republic of Palau -- -- -- -- --Rhode Island -- -- -- -- --South Carolina $2,047,031 85% $372,919 15% $2,419,950South Dakota $64,291 25% $190,416 75% $254,707Tennessee $1,193,340 100% $0 0% $1,193,340Texas $8,304,186 96% $302,222 4% $8,606,408Utah $297,492 90% $32,483 10% $329,975Vermont -- -- -- -- --Virgin Islands (U.S.) -- -- -- -- --Virginia $1,292,952 44% $1,622,842 56% $2,915,794Washington $229,203 30% $524,080 70% $753,283West Virginia $262,222 90% $27,719 10% $289,941Wisconsin $1,037,386 100% $0 0% $1,037,386Wyoming -- -- -- -- --Total $147,888,513 93% $11,220,371 7% $159,108,884

Note: 47 ADAPs reported data. American Samoa, Federated States of Micronesia, Kentucky, Marshall Islands, Mississippi, Northern Mariana Islands, Republic of Palau, Rhode Island, Vermont, Virgin Islands (U.S.) and Wyoming did not respond. A zero ($0) indicates the ADAP responded zero ($0) to the question.

Table 20: ADAP Drug Expenditures (Including Purchases and Co-payments), June 2014

62

State/Territory June 2014 Total Expenditures

June 2014 ARV Total Expenditures 1

ARV % of Total Expenditures 1

June 2014 "A1" OI Total Expenditures 2

"A1" OI % of Total

Expenditures 2

June 2014 All Other Total Expenditures

All Other % of Total

Expenditures

Alabama $1,401,102 $1,401,102 100% $0 0% $0 0%Alaska $93,018 $91,336 98% $1,632 2% $50 0.1%American Samoa -- -- -- -- -- -- --Arizona $654,009 $601,995 92% $6,119 1% $45,895 7%Arkansas $310,335 $300,000 97% $10,000 3% $335 0%California $28,494,106 $27,381,433 96% $236,305 1% $876,368 3%Colorado $664,952 $511,506 77% $6,257 1% $147,189 22%Connecticut $1,964,194 $1,800,970 92% $40,087 2% $123,137 6%Delaware $82,164 $74,038 90% $475 1% $7,651 9%District of Columbia $932,030 $899,045 96% $12,258 1% $20,727 2%Federated States of Micronesia -- -- -- -- -- -- --Florida $18,961,361 $18,757,957 99% $203,404 1% $0 0%Georgia $4,558,356 $4,499,282 99% $57,653 1% $1,421 0.03%Guam -- -- -- -- -- -- --Hawaii $114,829 $84,351 73% $260 0.2% $30,218 26%Idaho $239,686 $235,283 98% $4,403 2% $0 0%Illinois $3,246,767 $3,151,804 97% $31,394 1% $63,569 2%Indiana $606,108 $378,488 62% $14,024 2% $213,596 35%Iowa $66,922 $66,263 99% $370 1% $289 0.4%Kansas $815,207 $657,492 81% $9,208 1% $148,507 18%Kentucky -- -- -- -- -- -- --Louisiana $2,405,055 $1,912,660 80% $436,500 18% $55,895 2%Maine $69,164 $63,444 92% $306 0% $5,414 8%Marshall Islands -- -- -- -- -- -- --Maryland $2,967,028 $2,882,548 97% $43,523 1% $40,957 1%Massachusetts $424,640 $313,731 74% $7,262 2% $103,647 24%Michigan $2,884,729 $2,788,654 97% $27,750 1% $68,325 2%Minnesota $417,888 $417,888 100% $0 0% $0 0%Mississippi -- -- -- -- -- -- --Missouri $2,221,563 $1,546,475 70% $10,838 0% $664,250 30%Montana $141,820 $140,237 99% $156 0.1% $1,427 1%Nebraska $239,512 $230,889 96% $3,000 1% $5,623 2%Nevada3 $500,843 $486,432 97% $14,411 3% $0 0%New Hampshire $249,491 $212,069 85% $4,989 2% $32,433 13%New Jersey $7,188,239 $7,188,239 100% $0 0% $0 0%New Mexico $75,098 $73,849 98% $1,057 1% $192 0.3%New York $27,006,223 $25,016,294 93% $575,797 2% $1,414,132 5%North Carolina $3,906,936 $3,769,444 96% $40,365 1% $97,127 2%North Dakota $51,881 $49,749 96% $0 0% $0 0%Northern Mariana Islands -- -- -- -- -- -- --Ohio $1,467,062 $1,414,455 96% $10,064 1% $42,543 3%Oklahoma $211,614 $194,159 92% $2,311 1% $15,144 7%Oregon $1,129,918 $857,174 76% $30,168 3% $242,576 21%Pennsylvania $8,575,091 $7,700,942 90% $74,871 1% $799,278 9%Puerto Rico $15,969,159 $15,913,485 100% $14,381 0.1% $41,293 0.3%Republic of Palau -- -- -- -- -- -- --Rhode Island -- -- -- -- -- -- --South Carolina $2,419,950 $2,357,917 97% $17,513 1% $44,520 2%South Dakota $254,707 $243,038 95% $2,706 1% $8,963 4%Tennessee $1,193,340 $1,178,408 99% $14,669 1% $263 0.02%Texas $8,606,408 $8,532,259 99% $73,629 1% $520 0.01%Utah $329,975 $326,445 99% $3,530 1% $0 0%Vermont -- -- -- -- -- -- --Virgin Islands (U.S.) -- -- -- -- -- -- --Virginia $2,915,794 $2,831,834 97% $31,502 1% $52,458 2%Washington $753,283 $736,192 98% $640 0.1% $16,451 2%West Virginia $289,941 $277,382 96% $6,287 2% $6,272 2%Wisconsin $1,037,386 $1,013,623 98% $21,055 2% $2,708 0.3%Wyoming -- -- -- -- -- -- --Total $159,108,884 $151,562,260 95% $2,103,129 1% $5,441,363 3%1 ARV=Antiretrovirals.2 "A1" OI=Drugs recommended ("A1") for the prevention and treatment of opportunistic infections (OIs).

Note: 47 ADAPs reported data. American Samoa, Federated States of Micronesia, Kentucky, Marshall Islands, Mississippi, Northern Mariana Islands, Republic of Palau, Rhode Island, Vermont, Virgin Islands (U.S.) and Wyoming did not respond. A dash (--) indicates the ADAP did not report data. A zero ($0) indicates the ADAP responded zero ($0) to the question.

Table 21: ADAP Drug Expenditures (Including Purchases and Co-payments), by Drug Category, June 2014

63

State/TerritoryJune 2014 Drug Purchases Rx 1

Drug Purchases Rx % of Total Rx

June 2014 Co-Payment Rx

Co-Payment Rx % of Total Rx

June 2014 Total Rx

Alabama 2,974 100% 0 0% 2,974Alaska 75 31% 167 69% 242American Samoa -- -- -- -- --Arizona 1,872 32% 4,060 68% 5,932Arkansas 1,051 100% 0 0% 1,051California 68,737 100% 0 0% 68,737Colorado 838 14% 5,135 86% 5,973Connecticut 2,303 51% 2,224 49% 4,527Delaware 82,164 100% 0 0% 82,164District of Columbia 1,687 78% 478 22% 2,165Federated States of Micronesia -- -- -- -- --Florida 25,545 85% 4,340 15% 29,885Georgia 12,798 100% 0 0% 12,798Guam -- -- -- -- --Hawaii 201 32% 437 68% 638Idaho 281 100% 0 0% 281Illinois 7,605 83% 1,528 17% 9,133Indiana 1,121 36% 1,985 64% 3,106Iowa 104 19% 458 81% 562Kansas 306 17% 1,472 83% 1,778Kentucky -- -- -- -- --Louisiana 4,695 42% 6,450 58% 11,145Maine 41 4% 1,018 96% 1,059Marshall Islands -- -- -- -- --Maryland 3,597 37% 6,088 63% 9,685Massachusetts 655 5% 12,369 95% 13,024Michigan 8,145 100% 0 0% 8,145Minnesota 2,510 100% 0 0% 2,510Mississippi -- -- -- -- --Missouri 3,343 45% 4,057 55% 7,400Montana 75 23% 254 77% 329Nebraska 1,103 100% 0 0% 1,103Nevada 818 48% 880 52% 1,698New Hampshire 529 43% 710 57% 1,239New Jersey 20,692 75% 7,026 25% 27,718New Mexico 378 100% 0 0% 378New York 59,461 100% 0 0% 59,461North Carolina 13,069 86% 2,157 14% 15,226North Dakota 0 0% 160 100% 160Northern Mariana Islands -- -- -- -- --Ohio 1,424 54% 1,212 46% 2,636Oklahoma 352 11% 2,720 89% 3,072Oregon 10,937 100% 0 0% 10,937Pennsylvania 12,378 56% 9,647 44% 22,025Puerto Rico 39,306 94% 2,373 6% 41,679Republic of Palau -- -- -- -- --Rhode Island -- -- -- -- --South Carolina 6,165 32% 12,945 68% 19,110South Dakota 395 100% 0 0% 395Tennessee 2,793 100% 0 0% 2,793Texas 22,021 85% 3,750 15% 25,771Utah 638 81% 148 19% 786Vermont -- -- -- -- --Virgin Islands (U.S.) -- -- -- -- --Virginia 3,781 38% 6,219 62% 10,000Washington 392 12% 2,954 88% 3,346West Virginia 563 59% 386 41% 949Wisconsin 1,776 100% 0 0% 1,776Wyoming -- -- -- -- --Total 431,694 80% 105,807 20% 537,5011 Rx=Prescription

Note: 47 ADAPs reported data. American Samoa, Federated States of Micronesia, Kentucky, Marshall Islands, Mississippi, Northern Mariana Islands, Republic of Palau, Rhode Island, Vermont, Virgin Islands (U.S.) and Wyoming did not respond. A dash (--) indicates the ADAP did not report data. A zero (0) indicates the ADAP responded zero (0) to the question.

Table 22: ADAP Prescriptions Filled (Including Purchases and Co-payments), June 2014

64

State/TerritoryJune 2014 Total Rx 1

June 2014 ARV Total Rx 2

ARV % of Total Rx 2

June 2014 "A1" OI Total Rx 3

"A1" OI % of Total Rx 3

June 2014 All Other Total Rx

All Other Rx % of Total Rx

Alabama 2,974 2,974 100% 0 0% 0 0%Alaska 242 193 80% 24 10% 25 10%American Samoa -- -- -- -- -- -- --Arizona 5,932 2,446 41% 254 4% 3,232 54%Arkansas 1,051 1,000 95% 26 2% 25 2%California 68,737 42,433 62% 5,137 7% 21,167 31%Colorado 5,973 3,615 61% 381 6% 1,977 33%Connecticut 4,527 2,254 50% 391 9% 1,882 42%Delaware 82,164 74,038 90% 475 1% 7,651 9%District of Columbia 2,165 1,729 80% 127 6% 309 14%Federated States of Micronesia -- -- -- -- -- -- --Florida 29,885 27,527 92% 2,358 8% 0 0%Georgia 12,798 11,123 87% 1,675 13% 0 0%Guam -- -- -- -- -- -- --Hawaii 638 433 68% 35 5% 170 27%Idaho 281 244 87% 37 13% 0 0%Illinois 9,133 7,664 84% 414 5% 1,055 12%Indiana 3,106 786 25% 74 2% 2,246 72%Iowa 562 471 84% 35 6% 56 10%Kansas 1,778 1,311 74% 85 5% 382 21%Kentucky -- -- -- -- -- -- --Louisiana 11,145 7,861 71% 2,784 25% 500 4%Maine 1,059 521 49% 42 4% 496 47%Marshall Islands -- -- -- -- -- -- --Maryland 9,685 6,406 66% 340 4% 2,939 30%Massachusetts 13,024 4,251 33% 286 2% 8,487 65%Michigan 8,145 4,690 58% 517 6% 2,938 36%Minnesota 2,510 2,510 100% 0 0% 0 0%Mississippi -- -- -- -- -- -- --Missouri 7,400 3,116 42% 182 2% 4,102 55%Montana 329 308 94% 16 5% 5 2%Nebraska 1,103 772 70% 67 6% 264 24%Nevada4 1,698 1,241 73% 457 27% 0 0%New Hampshire 1,239 1,053 85% 25 2% 161 13%New Jersey 27,718 27,718 100% 0 0% 0 0%New Mexico 378 325 86% 1 0.3% 52 14%New York 59,461 30,278 51% 4,155 7% 25,028 42%North Carolina 15,226 9,876 65% 1,368 9% 3,982 26%North Dakota 160 130 81% 8 5% 22 14%Northern Mariana Islands -- -- -- -- -- -- --Ohio 2,636 1,823 69% 298 11% 515 20%Oklahoma 3,072 1,804 59% 174 6% 1,094 36%Oregon 10,937 3,467 32% 683 6% 6,787 62%Pennsylvania 22,025 8,700 40% 1,021 5% 12,304 56%Puerto Rico 41,679 34,653 83% 1,827 4% 5,199 12%Republic of Palau -- -- -- -- -- -- --Rhode Island -- -- -- -- -- -- --South Carolina 19,110 7,534 39% 2,336 12% 9,240 48%South Dakota 395 395 100% 0 0% 0 0%Tennessee 2,793 2,337 84% 272 10% 184 7%Texas 25,771 24,794 96% 943 4% 34 0.1%Utah 786 695 88% 91 12% 0 0%Vermont -- -- -- -- -- -- --Virgin Islands (U.S.) -- -- -- -- -- -- --Virginia 10,000 6,133 61% 849 8% 3,018 30%Washington 3,346 2,244 67% 117 3% 985 29%West Virginia 949 726 77% 69 7% 154 16%Wisconsin 1,776 1,459 82% 184 10% 133 7%Wyoming -- -- -- -- -- -- --Total 537,501 378,061 70% 30,640 6% 128,800 24%1 Rx=Prescription.2 ARV=Antiretrovirals.3 "A1" OI=Drugs recommended ("A1") for the prevention and treatment of opportunistic infections (OIs).

Note: 47 ADAPs reported data. American Samoa, Federated States of Micronesia, Kentucky, Marshall Islands, Mississippi, Northern Mariana Islands, Republic of Palau, Rhode Island, Vermont, Virgin Islands (U.S.) and Wyoming did not respond. A dash (--) indicates the ADAP did not report data. A zero (0) indicates the ADAP responded zero (0) to the question.

Table 23: ADAP Prescriptions Filled (Including Purchases and Co-payments), by Drug Category, June 2014

65

Full-Pay Rx Insurance Full-Pay Rx Insurance Full-Pay Rx Insurance

Alabama No No Yes Yes No NoAlaska Yes Yes Yes Yes Yes YesAmerican Samoa -- -- -- -- -- --Arizona Yes Yes Yes Yes Yes YesArkansas Yes Yes No No Yes YesCalifornia Yes Yes No No No NoColorado Yes Yes Yes Yes Yes YesConnecticut No No No No No NoDelaware No Yes No No Yes YesDistrict of Columbia No Yes No No No NoFederated States of Micronesia -- -- -- -- -- --Florida No Yes No No No No

Georgia Yes No No No No No

Guam -- -- -- -- -- --Hawaii Yes Yes Yes Yes Yes YesIdaho No No Yes No No NoIllinois Yes Yes Yes Yes Yes YesIndiana Yes Yes No No No NoIowa Yes Yes Yes Yes Yes YesKansas No No No No No NoKentucky -- -- -- -- -- --Louisiana No Yes No Yes No NoMaine No No No No No NoMarshall Islands -- -- -- -- -- --

Maryland No No No No No No

Massachusetts No No No No No NoMichigan Yes Yes Yes Yes Yes YesMinnesota Yes Yes No No No NoMississippi -- -- -- -- -- --Missouri No Yes No No No NoMontana Yes Yes Yes Yes No NoNebraska Yes Yes No No Yes YesNevada Yes Yes Yes Yes Yes YesNew Hampshire Yes Yes Yes Yes No NoNew Jersey Yes Yes Yes No No NoNew Mexico Yes Yes Yes Yes Yes YesNew York No No No No No NoNorth Carolina Yes Yes Yes Yes Yes YesNorth Dakota Yes Yes Yes Yes No NoNorthern Mariana Islands -- -- -- -- -- --Ohio Yes Yes Yes Yes No NoOklahoma Yes Yes Yes Yes Yes YesOregon Yes Yes No No No NoPennsylvania Yes Yes Yes No No NoPuerto Rico No No No No No NoRepublic of Palau -- -- -- -- -- --Rhode Island -- -- -- -- -- --South Carolina Yes Yes Yes Yes No NoSouth Dakota Yes Yes No No No NoTennessee Yes Yes Yes No Yes YesTexas No No No No No NoUtah Yes Yes No No No NoVermont -- -- -- -- -- --Virgin Islands (U.S.) -- -- -- -- -- --Virginia No Yes No No No NoWashington No Yes No No No NoWest Virginia Yes Yes No No No NoWisconsin Yes Yes Yes Yes No NoWyoming No No No No No NoTotal 30 36 22 19 15 15

Table 24: ADAP Prescription Distribution, June 2014

State/Territory

Mail Order Delivered to Client's Home Mail Order Delivered to Client's Clinic Central Pharmacy Pick-up


66

Full-Pay Rx Insurance Full-Pay Rx Insurance Full-Pay Rx Insurance Full-Pay Rx Insurance

Yes Yes No Yes No No No NoYes Yes No No Yes Yes No No-- -- -- -- -- -- -- --

Yes Yes Yes Yes Yes No No NoYes Yes No No Yes Yes No NoNo No Yes Yes Yes Yes No NoYes Yes Yes Yes Yes Yes No NoNo No Yes Yes No No No NoYes Yes No No Yes Yes No NoNo No No No Yes Yes No No-- -- -- -- -- -- -- --

Yes No No Yes Yes Yes No No

No No Yes Yes Yes No Pharmacy delivery service

Pharmacy delivery service

-- -- -- -- -- -- -- --Yes Yes Yes Yes Yes Yes No NoNo No No No No No No NoNo No No No No No No NoNo No Yes Yes No No No NoYes Yes No No No No No NoNo No No No Yes Yes No No-- -- -- -- -- -- -- --

Yes No No Yes No No No NoNo No Yes Yes No No No No-- -- -- -- -- -- -- --

No No No No No No Medicaid certified pharmacies

Medicaid certified pharmacies

No No Yes Yes No No No NoYes Yes Yes Yes Yes Yes No NoNo No Yes Yes No No No No-- -- -- -- -- -- -- --No No Yes Yes Yes Yes No NoNo No No No Yes Yes No NoNo No No Yes No Yes No NoYes No Yes Yes Yes No No NoNo No No No Yes Yes No NoNo No Yes No Yes No No NoYes Yes Yes Yes No No No NoNo No Yes Yes Yes Yes No NoYes Yes Yes Yes Yes Yes No NoNo No Yes Yes Yes Yes No No-- -- -- -- -- -- -- --No No No No No No No NoNo No Yes Yes Yes Yes No NoNo No Yes Yes Yes Yes No NoNo No Yes Yes No No No NoYes No No No Yes Yes No No-- -- -- -- -- -- -- ---- -- -- -- -- -- -- --No No No No No Yes No NoYes Yes No No No No No NoYes Yes No Yes Yes Yes No NoYes No No No Yes Yes No NoNo No No No Yes Yes No No-- -- -- -- -- -- -- ---- -- -- -- -- -- -- --

Yes Yes No Yes Yes No No NoNo No No No Yes Yes No NoNo No Yes Yes Yes Yes No NoNo No Yes Yes No No No NoNo No Yes Yes No No No No19 14 24 29 29 26 -- --

Table 24: ADAP Prescription Distribution, June 2014 (continued)

Client Choice of Pharmacy or Mail Order

Designated ADAP Pharmacy(ies) for Pick-up OtherCentral Pharmacy Distribution

67

State/Territory June 2014 Clients Served ADAP-Funded Insurance Premium Only 1

Deductible / Co-pay / Co-insurance Only

Premium and Deductible / Co-pay / Co-insurance

Alabama 90 0 0 90Alaska 72 26 0 46American Samoa -- -- -- --Arizona 870 128 462 280Arkansas 108 0 108 0California 9,618 238 7,234 2,146Colorado 1,464 915 21 528Connecticut 724 51 673 0Delaware 621 0 621 0District of Columbia 311 186 125 0Federated States of Micronesia -- -- -- --Florida 1,896 0 1,895 1Georgia 118 118 0 0Guam -- -- -- --Hawaii 158 14 127 17Idaho 0 0 0 0Illinois 878 242 409 227Indiana 2,203 0 433 1,770Iowa 203 6 171 26Kansas 552 -- -- --Kentucky -- -- -- --Louisiana 1,273 0 1,273 0Maine 371 43 289 39Marshall Islands -- -- -- --Maryland 2,127 702 1,145 280Massachusetts 3,594 758 2,192 644Michigan 1,514 0 927 587Minnesota 408 0 0 408Mississippi -- -- -- --Missouri 2,005 774 72 1,159Montana 95 2 28 65Nebraska 198 0 108 90Nevada 320 0 0 320New Hampshire 194 0 194 0New Jersey 140 140 0 0New Mexico 397 332 32 33New York 9,515 0 0 9,515North Carolina 639 0 639 0North Dakota 63 0 61 2Northern Mariana Islands -- -- -- --Ohio 1,051 75 895 81Oklahoma 1,063 236 280 547Oregon 2,782 1,340 430 1,012Pennsylvania 2,107 9 1,283 815Puerto Rico 490 0 490 0Republic of Palau -- -- -- --Rhode Island -- -- -- --South Carolina 1,261 0 1,116 145South Dakota 0 0 0 0Tennessee 2,376 418 912 1,046Texas 1,789 21 1,737 31Utah 233 164 46 23Vermont -- -- -- --Virgin Islands (U.S.) -- -- -- --Virginia 2,871 1,060 291 1,520Washington 2,048 51 16 1,981West Virginia 192 0 151 41Wisconsin 454 215 0 0Wyoming -- -- -- --Total 61,456 8,264 26,886 25,515

1 Clients for whom multiple months’ premiums (e.g. a payment was made in April for premium payments for April, May, and June) were paid should only be counted as one individual.

Note: 46 ADAPs reported data. American Samoa, Federated States of Micronesia, Kansas, Kentucky, Marshall Islands, Mississippi, Northern Mariana Islands, Republic of Palau, Rhode Island, Vermont, Virgin Islands (U.S.) and Wyoming did not respond. A dash (--) indicates the ADAP did not report data.

Table 25: Clients Served Through Insurance Purchasing and Continuation, 2014

68

Insurance Premiums Insurance Deductibles

Insurance Co-payments/Co-

insurance Other

Alabama $300,000 $8,136 $0 $54,707 $0Alaska $500,000 $156,945 $0 $0 $0American Samoa -- -- -- -- --Arizona $2,459,274 $87,973 $0 $302,749 $0Arkansas $300,000 $0 $12,000 $160,000 $0California $53,503,388 $995,457 $0 $1,436,584 $0Colorado $10,455,066 $211,586 $78,117 $287,406 $0Connecticut $4,500,000 $60,718 $72,505 $217,496 $0Delaware $104,000 $0 $0 $0 $0District of Columbia $1,000,000 $66,598 $0 $0 $22,018Federated States of Micronesia -- -- -- -- --Florida $13,000,000 $740,446 $0 $616,335 $3,689Georgia $5,500,416 $154,107 $0 $0 $0Guam -- -- -- -- --Hawaii $700,000 $12,567 $3,316 $22,381 $0Idaho $0 $0 $0 $0 $0Illinois $20,500,000 $356,040 $0 $0 $347,930Indiana $28,167,911 $2,034,988 $306,191 $0 $175,419Iowa $750,000 $16,238 $0 $0 $21,469Kansas $2,522,384 $96,604 $0 $732,474 $0Kentucky -- -- -- -- --Louisiana $28,082,807 $0 $0 $564,846 $0Maine $450,000 $16,429 $7,406 $25,315 $1,850Marshall Islands -- -- -- -- --Maryland $30,000,000 $861,839 $0 $538,047 $0Massachusetts $10,000,000 $585,709 $0 $196,284 $246,572Michigan $2,000,000 $144,186 $0 $915,414 $0Minnesota $3,586,978 $128,270 $0 $0 $0Mississippi -- -- -- -- --Missouri $7,366,914 $572,565 $36,478 $777,660 $0Montana $260,000 $260,000 $0 $700,000 $0Nebraska $1,500,000 $45,452 $0 $67,000 $0Nevada $1,400,000 $24,969 $0 $72,213 $0New Hampshire $649,721 $0 $0 $649,721 $0New Jersey $14,000,000 $627,409 $538,630 $0 $0New Mexico $1,841,358 $144,017 $11,364 $0 $0New York $84,000,000 $52,000,000 $0 $0 $32,000,000North Carolina $3,000,000 $0 $0 $164,084 $0North Dakota $200,000 $0 $0 $0 $83,704Northern Mariana Islands -- -- -- -- --Ohio $2,721,785 $453,583 $282 $60,166 $0Oklahoma $5,100,000 $285,129 $0 $132,521 $66,365Oregon $5,679,260 $205,891 $0 $228,205 $0Pennsylvania $400,000 $22,834 $0 $0 $568,499Puerto Rico $4,000,000 $0 $0 $319,901 $0Republic of Palau -- -- -- -- --Rhode Island -- -- -- -- --South Carolina $5,500,000 $143,942 $90,634 $174,409 $12,889South Dakota $0 $0 $0 $0 $0Tennessee $12,985,930 $304,819 $188,730 $324,405 $0Texas $7,469,568 $13,072 $0 $26,614 $0Utah $1,460,000 $56,922 $104,333 $34,715 $0Vermont -- -- -- -- --Virgin Islands (U.S.) -- -- -- -- --Virginia $31,564,713 $794,675 $0 $1,557,845 $0Washington $9,512,565 $1,397,987 $0 $91,031 $0West Virginia $400,000 $10,009 $0 $52,560 $0Wisconsin $1,575,000 $133,010 $0 $0 $0Wyoming -- -- -- -- --Total $420,969,038 $64,231,121 $1,449,986 $11,503,088 $33,550,404

Table 26: ADAP Funds Used and Clients Served Through Insurance Purchasing and Continuation, 2014


State/Territory FY2014 Estimated Expenditures

June 2014 Expenditures

69

Below 100% FPL

100-138% FPL

138-250% FPL

250-400% FPL

400% FPL and higher

Below 100% FPL

100-138% FPL

138-250% FPL

250-400% FPL

400% FPL and higher

Alabama No No No No No No No No No NoAlaska Yes Yes Yes No No Yes Yes Yes No NoAmerican Samoa -- -- -- -- -- -- -- -- -- --Arizona No No Yes Yes No No No Yes Yes NoArkansas No No No No No Yes Yes Yes Yes YesCalifornia Yes Yes Yes Yes Yes Yes 3 Yes 3 Yes 3 Yes 3 Yes 3

Colorado No No Yes Yes No No No Yes Yes YesConnecticut Yes Yes Yes Yes No Yes Yes Yes Yes NoDelaware No No Yes Yes Yes No No Yes Yes YesDistrict of Columbia No No Yes Yes Yes No No Yes Yes YesFederated States of Micronesia -- -- -- -- -- -- -- -- -- --Florida Yes Yes Yes Yes No Yes Yes Yes Yes NoGeorgia Yes Yes Yes Yes No No No No No NoGuam -- -- -- -- -- -- -- -- -- --Hawaii Yes Yes Yes Yes No Yes Yes Yes Yes NoIdaho No No No No No No No No No NoIllinois Yes Yes Yes Yes Yes Yes Yes Yes Yes YesIndiana No Yes Yes Yes No No Yes Yes Yes NoIowa No No Yes Yes No No No Yes Yes NoKansas Yes Yes Yes Yes No No No No No NoKentucky -- -- -- -- -- -- -- -- -- --Louisiana Yes Yes Yes Yes No Yes Yes Yes Yes NoMaine Yes Yes Yes Yes Yes Yes Yes Yes Yes YesMarshall Islands -- -- -- -- -- -- -- -- -- --Maryland Yes Yes Yes Yes Yes Yes Yes Yes Yes YesMassachusetts Yes Yes Yes Yes Yes No No No No NoMichigan No No Yes Yes Yes No No Yes Yes YesMinnesota Yes Yes Yes Yes Yes Yes Yes Yes Yes YesMississippi -- -- -- -- -- -- -- -- -- --Missouri Yes Yes Yes Yes No Yes Yes Yes Yes NoMontana Yes Yes Yes Yes No Yes Yes Yes Yes YesNebraska Yes Yes Yes No No Yes Yes Yes No NoNevada Yes Yes Yes Yes No Yes Yes Yes Yes NoNew Hampshire No No No No No Yes Yes Yes Yes NoNew Jersey No No No No No No No No No NoNew Mexico Yes Yes Yes Yes No Yes Yes Yes Yes NoNew York Yes Yes Yes Yes Yes Yes Yes Yes Yes YesNorth Carolina No No No No No Yes Yes Yes Yes NoNorth Dakota Yes Yes Yes Yes No Yes Yes Yes Yes NoNorthern Mariana Islands -- -- -- -- -- -- -- -- -- --Ohio Yes Yes Yes Yes No Yes Yes Yes Yes NoOklahoma Yes Yes Yes Yes Yes Yes Yes Yes Yes YesOregon Yes Yes Yes Yes No Yes Yes Yes Yes NoPennsylvania Yes Yes Yes Yes Yes Yes Yes Yes Yes YesPuerto Rico No No No No No Yes Yes Yes No NoRepublic of Palau -- -- -- -- -- -- -- -- -- --Rhode Island -- -- -- -- -- -- -- -- -- --South Carolina Yes Yes Yes Yes Yes Yes Yes Yes Yes YesSouth Dakota No No No No No No No No No NoTennessee Yes Yes Yes Yes No Yes Yes Yes Yes NoTexas Yes Yes Yes No No Yes Yes Yes No NoUtah Yes Yes Yes No No Yes Yes Yes No NoVermont -- -- -- -- -- -- -- -- -- --Virgin Islands (U.S.) -- -- -- -- -- -- -- -- -- --Virginia Yes Yes Yes Yes No Yes Yes Yes Yes NoWashington Yes Yes Yes Yes No Yes Yes Yes Yes NoWest Virginia No Yes Yes Yes No Yes Yes Yes Yes NoWisconsin Yes Yes Yes Yes No Yes Yes Yes Yes NoWyoming No No No No No Yes Yes Yes Yes NoTotal 31 33 39 35 13 33 34 40 35 14

State/TerritoryADAP Pays Premiums ADAP Pays Deductibles

Table 27: ADAP Policies Related to Insurance Purchasing as of June 30, 2014

3 California's ADAP assists enrolled clients in paying insurance deductibles for prescriptions only.

1 Federal ADAP funds cannot be used to pay for medical co-payments/co-insurance.2 The Affordable Care Act provides a new tax credit to help individuals afford health coverage purchased through the Marketplace. If a person qualifies, they may choose how much advance credit payments to apply to premiums each month, up to a maximum amount.

4 California's ADAP only requires a copy of clients' tax return be submitted as documentation of an advance tax credit within the ACA marketplace for clients enrolled in Covered California only.

Note: 48 ADAPs reported data. American Samoa, Federated States of Micronesia, Kentucky, Marshall Islands, Mississippi, Northern Mariana Islands, Republic of Palau, Rhode Island, Vermont and Virgin Islands (U.S.) did not respond. A dash (--) indicates the ADAP did not report data or responded "no."

70

Below 100% FPL

100-138% FPL

138-250% FPL

250-400% FPL

400% FPL and higher

Below 100% FPL

100-138% FPL

138-250% FPL

250-400% FPL

400% FPL and higher

100-138% FPL

138-250% FPL

100-138% FPL

138-250% FPL

No No No No No No No No No No NA NA NA NAYes Yes Yes No No No No No No No Yes Yes Yes Yes-- -- -- -- -- -- -- -- -- -- -- -- -- --No No Yes Yes No No No Yes Yes No No Yes NA YesYes Yes Yes Yes Yes No No No No No Yes Yes Yes YesYes Yes Yes Yes Yes No No No No No NA Yes NA Yes 4

No No Yes Yes Yes No No Yes Yes No Yes Yes Yes YesYes Yes Yes Yes No Yes Yes Yes Yes No Yes Yes NA NANo No Yes Yes Yes No No Yes Yes Yes No Yes Yes YesNo No Yes Yes Yes No No Yes Yes Yes No No NA NA-- -- -- -- -- -- -- -- -- -- -- -- -- --

Yes Yes Yes Yes No No No No No No Yes Yes Yes YesNo No No No No No No No No No Yes Yes No No-- -- -- -- -- -- -- -- -- -- -- -- -- --

Yes Yes Yes Yes No No No No No No Yes Yes NA NANo No No No No No No No No No NA NA NA NAYes Yes Yes Yes Yes No No No No No Yes Yes Yes YesNo Yes Yes Yes No No Yes Yes Yes No No No NA NANo No Yes Yes No No No No No No Yes Yes Yes YesYes Yes Yes Yes No Yes Yes Yes Yes No Yes Yes Yes Yes-- -- -- -- -- -- -- -- -- -- -- -- -- --

Yes Yes Yes Yes No Yes Yes Yes Yes No Yes Yes NA NAYes Yes Yes Yes Yes No No No No No Yes Yes No No-- -- -- -- -- -- -- -- -- -- -- -- -- --

Yes Yes Yes Yes Yes No No No No No Yes Yes Yes YesYes Yes Yes Yes Yes No No No No No Yes Yes Yes YesNo No Yes Yes Yes No No Yes Yes Yes No Yes No YesYes Yes Yes Yes Yes No No No No No No Yes NA Yes-- -- -- -- -- -- -- -- -- -- -- -- -- --

Yes Yes Yes Yes No Yes Yes Yes Yes No Yes Yes Yes YesYes Yes Yes Yes Yes No No No No No Yes Yes Yes YesYes Yes Yes No No Yes Yes Yes No No Yes Yes Yes YesYes Yes Yes Yes No No No No No No No Yes Yes YesYes Yes Yes Yes No No No No Yes No Yes Yes Yes YesNo No No No No No No No No No NA NA NA NAYes Yes Yes Yes No No Yes Yes Yes No Yes Yes Yes YesYes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes NA NAYes Yes Yes Yes No No No No No No No No NA NAYes Yes Yes Yes No Yes Yes Yes Yes No Yes Yes Yes Yes-- -- -- -- -- -- -- -- -- -- -- -- -- --

Yes Yes Yes Yes No Yes Yes Yes Yes No No Yes No YesYes Yes Yes Yes Yes No No No No No Yes Yes Yes YesYes Yes Yes Yes No Yes Yes Yes Yes No Yes Yes Yes YesYes Yes Yes Yes Yes No No No No No No No NA NAYes Yes Yes No No No No No No No No No NA NA-- -- -- -- -- -- -- -- -- -- -- -- -- ---- -- -- -- -- -- -- -- -- -- -- -- -- --

Yes Yes Yes Yes Yes No No No No No No Yes NA NoYes Yes Yes Yes No No No No No No No No Yes YesYes Yes Yes Yes No Yes Yes Yes Yes No Yes Yes Yes YesYes Yes Yes No No No No No No No No No NA NAYes Yes Yes No No No No No No No Yes Yes No No-- -- -- -- -- -- -- -- -- -- -- -- -- ---- -- -- -- -- -- -- -- -- -- -- -- -- --

Yes Yes Yes Yes No No No No No No Yes Yes No NoYes Yes Yes Yes No Yes Yes Yes Yes No Yes Yes NA NAYes Yes Yes Yes No Yes Yes Yes Yes No Yes Yes Yes YesYes Yes Yes Yes No No No No No No Yes Yes Yes YesYes Yes Yes Yes No No No No No No No No NA NA37 38 44 39 16 12 14 19 19 4 28 37 23 27

ADAP Pays Co-payments / Co-insurance (prescription only)

Table 27: ADAP Policies Related to Insurance Purchasing as of June 30, 2014 (continued)

ADAP Pays Co-payments / Co-insurance (medical only 1)ADAP Requires Advance

Tax Credit 2ADAP Requires Tax Return

Submission

71

Partial Subsidy Clients

Standard Clients


Standard Clients

Dually Eligible Clients

Full Subsidy Clients


Standard Clients

Dually Eligible Clients

Full Subsidy Clients


Standard Clients

Alabama No Yes No Yes No Yes No Yes No Yes No Yes YesAlaska No No Yes Yes No Yes Yes Yes No Yes Yes Yes YesAmerican Samoa -- -- -- -- -- -- -- -- -- -- -- -- --Arizona No No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes YesArkansas Yes No Yes No No No Yes No No No No No NoCalifornia Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes YesColorado Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes YesConnecticut Yes Yes Yes Yes No Yes Yes Yes No Yes Yes Yes YesDelaware Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes YesDistrict of Columbia No No No No No No No No No No No No NoFederated States of Micronesia -- -- -- -- -- -- -- -- -- -- -- -- --Florida No No Yes Yes Yes No Yes Yes Yes No Yes Yes YesGeorgia Yes Yes No No No No No No No No Yes Yes YesGuam -- -- -- -- -- -- -- -- -- -- -- -- --Hawaii No No Yes Yes No Yes Yes Yes No Yes Yes Yes YesIdaho No No No No No No No No No No No No YesIllinois Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes YesIndiana No No Yes Yes No Yes Yes Yes No Yes Yes Yes YesIowa No No Yes Yes Yes No Yes Yes Yes No Yes Yes YesKansas No No No No Yes Yes Yes Yes Yes Yes Yes Yes YesKentucky -- -- -- -- -- -- -- -- -- -- -- -- --Louisiana Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes YesMaine No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes YesMarshall Islands -- -- -- -- -- -- -- -- -- -- -- -- --Maryland Yes Yes Yes Yes No Yes Yes Yes No Yes Yes Yes YesMassachusetts Yes Yes No No Yes Yes Yes Yes Yes Yes Yes Yes YesMichigan Yes Yes Yes Yes No Yes Yes Yes No Yes Yes Yes YesMinnesota No Yes Yes Yes No No Yes Yes No No Yes Yes YesMississippi -- -- -- -- -- -- -- -- -- -- -- -- --Missouri No No No No No No No No No No No No YesMontana No No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes YesNebraska No No No No No Yes Yes Yes No Yes Yes Yes YesNevada Yes Yes Yes Yes Yes Yes Yes Yes No No No No YesNew Hampshire No No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes YesNew Jersey Yes Yes Yes Yes Yes Yes Yes Yes No No No No YesNew Mexico No No No No No No No No No No No No NoNew York Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes YesNorth Carolina No No Yes Yes No Yes Yes Yes No Yes Yes Yes YesNorth Dakota Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes YesNorthern Mariana Islands -- -- -- -- -- -- -- -- -- -- -- -- --Ohio Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes YesOklahoma Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes YesOregon Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes YesPennsylvania Yes Yes Yes Yes No Yes Yes Yes No Yes Yes Yes YesPuerto Rico No No Yes Yes No Yes Yes Yes No Yes Yes Yes YesRepublic of Palau -- -- -- --- -- -- -- -- -- -- -- -- --Rhode Island -- -- -- -- -- -- -- -- -- -- -- -- --South Carolina No No Yes Yes No No Yes Yes No No Yes Yes YesSouth Dakota No No No No Yes Yes Yes Yes Yes Yes Yes Yes YesTennessee No No No No No No No No No No No No NoTexas No No Yes Yes No No Yes Yes No No No No YesUtah Yes Yes Yes Yes No Yes Yes Yes No Yes Yes Yes YesVermont -- -- -- -- -- -- -- -- -- -- -- -- --Virgin Islands (U.S.) -- -- -- -- -- -- -- -- -- -- -- -- --Virginia Yes Yes Yes Yes No No Yes Yes No No Yes Yes YesWashington Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes YesWest Virginia No No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes YesWisconsin Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes YesWyoming No No Yes Yes No No No No Yes Yes Yes Yes YesTotal 23 25 37 36 23 34 40 40 23 33 38 39 44

Table 28: ADAP Policies Related to Medicare Part D, as of June 30, 2014


State/Territory

ADAP Pays Premiums ADAP Pays Deductibles ADAP Pays Co-payments Eligible for ADAP Provide Medications

During the Donut Hole

72

73

State/Territory Client Cost-Sharing Overall Program Enrollment Cap Drug Specific Enrollment Cap Maximum Cost Per Client

Alabama No No No NoAlaska No No No NoAmerican Samoa -- -- -- --Arizona No No No NoArkansas No No No NoCalifornia Yes No No NoColorado No No No NoConnecticut No No No NoDelaware No No No NoDistrict of Columbia No No No NoFederated States of Micronesia -- -- -- --Florida No No No NoGeorgia No No Yes NoGuam -- -- -- --Hawaii No No Yes NoIdaho No Yes Yes NoIllinois No No Yes YesIndiana No Yes No NoIowa No No No NoKansas No No No NoKentucky -- -- -- --Louisiana No No No NoMaine No No No NoMarshall Islands -- -- -- --Maryland No No No NoMassachusetts No No No NoMichigan No No No NoMinnesota No No No NoMississippi -- -- -- --Missouri No No No NoMontana No No Yes NoNebraska No No No NoNevada No No No NoNew Hampshire No No No NoNew Jersey No No No NoNew Mexico Yes No No NoNew York No No No NoNorth Carolina No No No NoNorth Dakota No Yes No NoNorthern Mariana Islands -- -- -- --Ohio No No No NoOklahoma No No No NoOregon Yes No No NoPennsylvania No No No NoPuerto Rico No No No NoRepublic of Palau -- -- -- --Rhode Island -- -- -- --South Carolina No No No NoSouth Dakota No No No YesTennessee No No No NoTexas No No No NoUtah No Yes No NoVermont -- -- -- --Virgin Islands (U.S.) -- -- -- --Virginia No No No NoWashington Yes No No NoWest Virginia No No No NoWisconsin No No No NoWyoming No No No NoTotal 4 4 5 2

Table 29: ADAP Management Practices in Place, as of June 30, 2014

1 ADAP practices are defined as those dictated by the ADAP, not inclusive of those required by individual insurance plans through which the ADAP may provide insurance coverage to clients.

2 Step therapy - The practice of beginning drug therapy for a medical condition with the most cost-effective and safest drug therapy and progressing to other more costly or risky therapy, only if necessary. The aims are to control costs and minimize risks. Also called step protocol. Step therapy does not apply to antiretrovirals.


74

Maximum Number of Prescriptions Per Client Per

Month

Drug(s) with Prior Authorization Drug(s) with Clinical Criteria Drug(s) with Required

Resistance Testing Step Therapy 2 Other

No Yes Yes Yes No NoNo No No No No No-- -- -- -- -- --No Yes Yes No No YesNo Yes No No No NoNo Yes Yes No Yes NoNo Yes No No No NoNo Yes Yes No No NoNo No Yes No No NoNo Yes No No No No-- -- -- -- -- --No Yes Yes No No NoNo Yes Yes Yes No No-- -- -- -- -- --No No Yes No No NoNo Yes No No No NoNo Yes No Yes No NoNo Yes No No No NoNo No No No No NoNo Yes Yes No No No-- -- -- -- -- --No No No No No NoNo Yes Yes No No No-- -- -- -- -- --No Yes Yes No No NoNo Yes No No No NoNo Yes No No Yes NoNo Yes No No No No-- -- -- -- -- --No No No No No NoNo Yes Yes Yes No NoNo Yes No No No NoNo Yes No No No NoNo Yes Yes No Yes NoNo Yes Yes No No NoNo No No No No NoNo No Yes Yes No YesNo No No No No NoNo No No No No No-- -- -- -- -- --No Yes Yes No No NoNo No No No No NoNo No No No No NoNo No No No No YesNo Yes Yes No No No-- -- -- -- -- ---- -- -- -- -- --No No Yes Yes No NoNo No No No No NoNo No No No No NoYes No No No No NoNo No No No No No-- -- -- -- -- ---- -- -- -- -- --No No No No No NoNo No Yes Yes No NoNo Yes Yes No Yes NoNo No No No No NoNo Yes No No Yes No1 27 20 7 3

Table 29: ADAP Management Practices in Place, as of June 30, 2014 (continued)

75

1987

1990

1995

1996

2000

2003

2004

2006

2007

2009

2010

2011

2012

2013

2014

Table 30: Key Dates in the History of ADAP

The first open enrollment period for insurance through the insurance marketplace established under the Affordable Care Act ends on March 31, 2014.

ADAP emergency funding continued at $40 million. In December 2011, President Obama announced an additional $35 million for ADAPs to address ADAP waiting lists and cost containment measures. Awards from this funding will be available to states based on a competitive application.

ADAP emergency funding awarded at $75 million, including the continuation of FY2011 funding the allocation of an additional $35 million announced by President Obama in December 2011.

NASTAD’s ADAP Crisis Task Force formed to negotiate with pharmaceutical companies on pricing of antiretroviral medications; first fusion inhibitor approved by FDA.

President’s ADAP Initiative (PAI) announced, allocating $20 million in one-time funding outside of the ADAP system to reduce ADAP waiting lists in 10 states.

Third reauthorization of the CARE Act, now called, “Title XXVI of the PHS Act as amended by the Ryan White HIV/AIDS Treatment Modernization Act of 2006” or the “Ryan White Program.” Changes for ADAP include: new formula for determining state awards, which incorporates living HIV and AIDS cases; new minimum formulary requirement; and an increase in the ADAP Supplemental set-aside and changes in eligibility and matching requirements.

New minimum formulary requirement effective July 1; first CCR5 antagonist and integrase inhibitor approved by FDA.

Fourth reauthorization of the Ryan White Program. The reauthorization was for four years and included several technical changes.

Patient Protection and Affordable Care Act (PPACA) signed into law. ADAP emergency funding announced by the Obama Administration, allocating $25 million in funding to address ADAP waiting lists and cost-containment measures.

Open enrollment for insurance through the insurance marketplace established under the Affordable Care Act begins on October 1.

Second reauthorization of CARE Act. Changes for ADAPs include: allowance of insurance purchasing and maintenance; flexibility to provide other limited services (e.g., adherence support and outreach); and creation of ADAP supplemental grants program.

First antiretroviral (AZT, an NRTI) approved by the FDA; Federal government provides grants to states to help them purchase AZT, marking beginning of federally funded, state-administered “AZT Assistance Programs.”

ADAPs incorporated into Title II of the newly created Ryan White CARE Act.

First protease inhibitor approved by FDA, and the highly active antiretroviral therapy (HAART) era begins.

First reauthorization of CARE Act—federal ADAP earmark created; first non-nucleoside reverse transcriptase inhibitor (NNRTI) approved by FDA.

76

GENERIC NAME BRAND NAME

cobicistat Tybost

efavirenz, emtricitabine, and tenoforvir disoproxil fumarate Atriplarilpivirine, emtricitabine, and tenoforvir disoproxil fumarate Compleraelvitegravir, cobicistat, emtricitabine, and tenofovir disoproxil fumarate Stribild

abacavir sulfate, ABC Ziagenabacavir, zidovudine, and lamivudine Trizivirabacavir and lamivudine Epzicomdidanosine, dideoxyinosine, ddL Videxemtricitabine, FTC Emtrivalamivudine and zidovudine Combivirlamivudine, 3TC Epivirstavudine, d4T Zerittenofovir, disoproxil fumarate, TDF Vireadtenofovir disoproxil fumarate and emtricitabine Truvadazidovudine, azidothymidine, AZT, ZDV Retrovir

delavirdine, DLV Rescriptorefavirenz, EFV Sustivaetravirine Intelencenevirapine, NVP Viramunerilpivirine Edurant

amprenavir, APV Agenerase 1

atazanavir sulfate, ATV Reyatazdarunavir Prezistafosamprenavir calcium, FOS-APV Lexivaindinavir, IDV Crixivanlopinavir and ritonavir, LPV/RTV Kaletranelfinavir mesylate, NFV Viraceptritonavir, RTV Norvirsaquinavir mesylate, SQV Invirasetipranavir, TPV Aptivus

enfuvirtide, T-20 Fuzeon

maraviroc Selzentry

dolutegravir Tivicayelvitegravir Vitektaraltegravir Isentress

abacavir/lamivudine, dolutegravir Triumeq

GENERIC NAME BRAND NAMEacyclovir Zoviraxamphotericin B Fungizoneazithromycin Zithromaxcidofovir Vistideclarithromycin Biaxinclindamycin Cleocinethambutol --famciclovir Famvirfluconazole Diflucanflucytosine Ancobonfoscarnet Foscavirganciclovir Cytoveneisoniazid (INH) Lanizid, Nydraziditraconazole Sporonoxleucovorin calcium Wellcovorinliposomal amphotericin B --peg-interferon alfa-2a PEG-Intronpeg-interferon alfa-2b --pentamidine Nebupentprednisone Deltasone, Liquid Pred, Metocorten, Orasone, Panasol, Prednicen-M, Sterapredprobenecid --pyrazinamide (PZA) --pyrimethamine Daraprim, Fansidarribavirin Virazole, Rebetol, Copegusrifabutin Mycobutinrifampin (RIF) Rifadin, Rimactanesulfadiazine (oral generic) Microsulfontrimethoprim- sulfamethoxazole (TMP/SMX) Bactrim, Septravalacyclovir Valtrexvalganciclovir Valcyte

Table 31: HIV/AIDS Antiretroviral and Opportunistic Infection Medications

Protease Inhibitors

FDA-Approved Antiretroviral Medications

Multi-Class Combination Products

NRTIs

NNRTIs

CYP34A Inhibitors (Pharmocokinetic Boosters)

Source: FDA, "Drugs Used in the Treatment of HIV Infection": http://www.fda.gov/oashi/aids/virals.html. Also see: DHHS, "Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents," December 16, 2013: http://aidsinfo.nih.gov/contentfiles/lvguidelines/AdultandAdolescentGL.pdf.

"A1" Medications for the Prevention & Treatment of Opportunistic Infections (Highly Recommended) 1

1 "A" = "should always be offered"; "1" = "evidence from at least one properly randomized, controlled trial"

Sources: CDC, "Guidelines for the Prevention of Opportunistic Infections in Persons Infected with Human Immunodeficiency Virus." MMWR, 51 (No. RR08),1-46; 2002; CDC, "Treating Opportunistic Infections Among HIV-Infected Adults and Adolescents." MMWR, 53 (No. RR15), 1-112; 2004. Also see: DHHS, "Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents," December 16, 2013: http://aidsinfo.nih.gov/contentfiles/lvguidelines/AdultandAdolescentGL.pdf.

Fusion Inhibitors

Entry Inhibitors - CCR5 Co-Receptor Antagonist

HIV Integrase Strand Transfer Inhibitors

1 The manufacturer of Agenerase (amprenavir) discontinued the sale and distribution of the drug in capsule form, used for adult dosing, after 2004 and is instead manufacturing fosamprenavir (Lexiva), a "prodrug" of Agenerase (a prodrug is an inactive precursor of a drug, converted into its active form in the body). Agenerase is still availabe in pediatric dosing.

HIV Integrase Strand Transfer Inhibitor and NRTI Combinations

77

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