Tuesday, March 9, 1999 POLITICS & POLICY ADAPs: Costs and Use Continue to Increase       Although the country's AIDS Drug Assistance Programs served 22% more clients between July 1997 and June 1998, some state's programs still have unmet needs and restrict access due to budgetary constraints and the increasing cost of antiretroviral drugs. The National ADAP Monitoring Project: Annual Report, March 1999, commissioned by the Kaiser Family Foundation and conducted by the National Alliance of State and Territorial AIDS Directors and the AIDS Treatment Data Network, found that ADAP program expenditures grew by 37% over that one-year period due to increases in per client expenditures, number of clients served and cost and use of combination antiretroviral drug therapies. Per client expenses rose 12%, and spending for antiretroviral drugs grew by 54%. By June of 1998, the cost of such drugs represented 88% of overall ADAP expenditures. The survey also found that spending for drugs that treat and prevent opportunistic infections and other formulary drugs decreased by 31%. Tim Westmoreland, senior advisor on HIV/AIDS at the Kaiser Family Foundation, said, "The good news is that the new antiretrovirals extend the life and health of people with HIV. But these drugs are doubly expensive. Not only do they cost more than the previous drugs, treatment guidelines indicate that more people should take them earlier in their illness." In addition to detailing how ADAP funding is being used, the report describes how states are stretching their resources, what unmet needs exist and who ADAP clients are. Joseph Kelly, deputy director of NASTAD and co-author of the report, said, "While some ADAPs have stable, adequately funded programs to respond to client demand, there are persistent program restrictions and budget shortages among nearly half the states, which continue to limit drug coverage and program access for low income clients with HIV disease." The report is available at http://204.179.124.69/adap/index.html, or can be ordered through the Kaiser Family Foundation's toll-free publications request line at 1-800-656-4KFF (report #1467) (Kaiser release, 3/9). Kaiser Daily HIV/AIDS Report