Austin’s Dwayne Haught Helps States Score AIDS Drug Price Cuts for Poor
Health department representatives from eight states, including Texas, have secured significant price cuts for the drugs used by state AIDS drug assistance programs. Austin’s Dwayne Haught RN — coordinator of Texas’ ADAP, the Texas HIV Medications Program — was a key participant in the grueling six months of negotiations, which pried $65 million from the eight primary AIDS drug manufacturers.
Nationally, ADAPs provide HIV medications for about 84,000 poor, uninsured, and underinsured HIV-positive people at a cost of about $850 million each year. The THMP serves about 12,000 people, almost one-fourth of all HIV-infected Texans.
ADAPs across the country are facing budget shortfalls: Fifteen states have waiting lists or access restrictions, and six more are contemplating the same. Texas, which already has a very modest ADAP, revised its participation rules in early August to allow for implementing cost-savings measures, should they be needed, because the Legislature did not provide sufficient funding to carry THMP fully through the two-year budget cycle without changes. However, with this pricing success and other adjustments (such as a possible increase in federal funding), Dwayne is cautiously optimistic that Texas may not have to impose any of the measures in FY 2004.
This agreement was the first time that all the states negotiated jointly, rather than leaving each state’s ADAP to fend for itself. The eight states represented on the team? California, Florida, Maryland, Massachusetts, New Jersey, New York, North Carolina, and Texas — they collectively account for 75% of annual ADAP drug expenditures. That’s enough bargaining power to go bear hunting; individual states have much less leverage.
Our hearty congratulations to Dwayne Haught and his team for an accomplishment which will help poor and uninsured HIV-positive Texans maintain the best possible health by supporting uninterrupted access to life-saving medications. We’ll hope for even greater gains in future talks.
This article appears in August 29 • 2003.