Fact sheet: the north carolina hiv medications program

FACT SHEET: The North Carolina HIV Medications/AIDS Drug Assistance Program (ADAP)
HIV/STD Prevention and Care Branch - Division of Public Health, NC DHHS
What is the North Carolina
HIV Medications Program?
The North Carolina HIV Medications Program, also referred to as the AIDS Drug Assistance Program (ADAP), uses a combination of State and federal funds to provide low-income residents of the State with assistance in obtaining essential, life-sustaining medications to fight HIV/AIDS and the opportunistic infections which often accompany the disease. The Program purchases the medications in bulk from a pharmaceutical wholesaler, and a central pharmacy dispenses and sends the prescriptions for each client to the client’s designated address. Who is eligible to participate in the Program?
In order for someone to be eligible for ADAP, the individual must: • Have a net family income that is at or below 125% of the federal poverty level (see the back of this page for the current FPL for various family sizes); • Not have other third-party coverage (e.g., private insurance or Medicaid) that pays for medications; and, • Have a (or several) prescription(s) for medications that are included in the ADAP formulary (list of drugs that the Program will pay for) – (The medications provided under this Program are limited to those specifically related to the diagnosis and treatment of HIV disease/AIDS - see the back of this page for the current ADAP formulary) How does someone apply to and get into the Program?
An individual who wants to apply for ADAP coverage should talk to their clinician or the person in the office who handles bills and/or insurance, their HIV case manager, or someone at one of NC’s HIV Care Consortia, at any local/public health department, or at an AIDS service organization/agency. The applicant, with the assistance of these individuals, will complete two forms; one to establish that the individual qualifies financially for the Program and one to document their HIV+ status, their need for medications provided under this Program and a mailing/delivery address for the medications. These two forms are then sent to the Office of Purchase of Medical Care Services for a final determination of eligibility. The individual and their “case manager” will be advised if the applicant is eligible for and if they have been enrolled in the Program. Prescription information may either be captured on the central pharmacy’s enrollment form and faxed to the central pharmacy or the actual prescriptions may be mailed to the central pharmacy. These three forms, along with the POMCS provider/instruction manual can be found and downloaded at Is there any cost to the individual?
There is no cost to the individual covered under this Program for the drugs that are on the Program’s formulary. The individual is responsible for the cost of other drugs that they receive which are not covered by the Program. How does someone get more information about the HIV Medications Program?
For more information about the HIV Medications Program, please go to , or you may contact: • Steve Sherman – Coordinator, NC AIDS Drug Assistance/HIV Medications Program (ADAP), HIV/STD Prevention • Sally Kohls – Nurse Consultant, ADAP, HIV/STD Prevention and Care Branch – (919) 733-9602 or • Purchase of Medical Care Services (applications are processed by the client’s last name alphabetically) - • (A-D) - Toni Wallace - (919) 855-3668 • (L-P, R) - Debbie Pollard - (919) 855-3667 • (E-K) - Mike Benson - (919) 855-3666 • (Q, S-Z) - Glenys Spencer - (919) 855-3665. [Please see the other side of this page for additional information] Family Size / Federal Poverty Level ($)
As of April 1, 2006
Note: As of January 1, 2006, NC's ADAP financial eligibility is at or below 125% of the FPL. HIV MEDICATIONS/ADAP PROGRAM
Listing of Covered Medications
As of January 1, 2006

(FDA approved)
amprenavir – Agenerase
delavirdine - Rescriptor
tipranavir - Aptivus
zidovudine (AZT) – Retrovir
zidovudine and lamivudine – Combivir
atazanavir – Reyataz
indinavir – Crixivan
efavirenz – Sustiva
emtricitabine – Emtriva
zidovudine, lamivudine and abacavir –Trizivir
lamivudine (3TC) – Epivir
tenofovir and emtricitabine – Truvada
abacavir and lamivudine - Epzicom
didanosine (ddI) – Videx
enfuvirtide – Fuzeon *
nelfinavir - Viracept
zalcitibine (ddC) - Hivid
nevirapine – Viramune
saquinivir - Invirase, Fortovase
tenofovir – Viread
lopinavir/ritonavir – Kaletra
stavudine (d4T) – Zerit
fosamprenavir - Lexiva
abacavir – Ziagen
ritonavir - Norvir
* Access to Fuzeon is governed by special medical eligibility/appropriateness criteria, including a separate approved application Other Medications:
acyclovir -- Zovirax
atovaquone -- Mepron
azithromycin -- Zithromax
clarithromycin -- Biaxin
clindamycin -- Cleocin
dapsone (DDS) -- Dapsone
ethambutol -- Myambutol
fluconazole -- Diflucan
ganciclovir (DHPG) -- Cytovene
hydroxyurea --Hydrea
itraconozole -- Sporanox ketoconazole
nystatin -- Mycostatin, Nilstat
paromomycin -- Humatin
pentamidine -- NebuPent
pyramethamine -- Daraprim rifabutin
omeprazole -- Prilosec
lansoprazole -- Prevacid
ondansetron hydrochloride -- Zofran
prochlorperazine -- Compazine promethazine -- Phenergan
loperamide -- Imodium
amitriptyline -- Elavil
nortriptyline -- Aventyl, Pamelor
pancrelipase -- Pancreas MT-20
famciclovir -- Famvir
valacyclovir -- Valtrex
ciproflaxicin hydrochloride -- CIPRO
diphenoxylate hydrochloride with atropine sulfate -- Lomotil
sulfamethoxazole/trimethoprim (smx/tmp; tmp-smx) -- Bactrim, Septra, Cotrim, Sulfatrim
valganciclovir hydrochloride --
Notes: (1) These are examples of brand names and not meant to be all inclusive (2) Generic medications are dispensed unless the prescription is written for a specific brand name Decisions about what medications are included within the Program formulary are guided by an HIV Clinical/Medications Advisory Committee. Members of this Committee (clinicians, case managers, HIV program administrators, consumers and others), provide their expertise and perspectives primarily on issues related to the efficacy and importance of new medications. The also provide advice on activities related to the operation and effectiveness of the Program. Their perspectives and best thinking on these issues are integrated with considerations about budgetary status and Program/policy regulations and priorities. While final decisions with regard to all of these matters rest with the State agency responsible for administering the Program (i.e., the HIV/STD Prevention and Care Branch of the Division of Public Health, Department of Health and Human Services), the HIV Clinical/Medications Advisory Committee plays an invaluable role in assuring that “real world” experience and expertise are incorporated into the decisions made by and operation of the Program. [Please see the other side of this page for additional information]

Source: http://picnetwork.wikispaces.com/file/view/ADAP+Facts+and+Meds.pdf

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