NATIONAL ADAP MONITORING PROJECT

ANNUAL REPORT April 2002

Prepared by Chris Aldridge Danielle Davis Arnold Doyle National Alliance of State and Territorial AIDS Directors Jennifer Kates The Henry J. Kaiser Family Foundation Lei Chou AIDS Treatment Data Network

The Henry J. Kaiser Family Foundation is an independent, national health philanthropy dedicated to providing information and analysis on health issues to policymakers, the media, and the general public. The Foundation is not associated with Kaiser Permanente or Kaiser Industries.

NATIONAL ADAP MONITORING PROJECT

ANNUAL REPORT April 2002

Prepared by Chris Aldridge Danielle Davis Arnold Doyle National Alliance of State and Territorial AIDS Directors Jennifer Kates The Henry J. Kaiser Family Foundation Lei Chou AIDS Treatment Data Network

Acknowledgements The Henry J. Kaiser Family Foundation, The National Alliance of State and Territorial AIDS Directors (NASTAD) and the AIDS Treatment Data Network (ATDN) would like to thank the state ADAP and AIDS program managers and staff for their time and efforts in completing the National ADAP Survey, June 2001, which serves as the foundation for this report. The authors also wish to thank Murray Penner (NASTAD) and Ardine Hockaday (Kaiser Family Foundation) for their research and graphic design assistance.

About AIDS Drug Assistance Programs In 1987, Congress first appropriated funds to assist states in providing the relatively costly drug AZT [the first antiretroviral approved by the Food and Drug Administration (FDA)] to AIDS patients. State health departments were directed by Congress to use these AZT Assistance Program funds to purchase and deliver AZT to eligible individuals. As AIDS treatment options increased and resources allowed, AZT Assistance Programs began to cover other approved antiretroviral medications and drugs to prevent and treat opportunistic infections. These programs were incorporated into Title II of the Ryan White CARE Act upon its initial passage in 1990 and became commonly known as AIDS Drug Assistance Programs (ADAPs). ADAPs provide FDA approved HIV-related prescription drugs to underinsured and uninsured individuals living with HIV/AIDS. The CARE Act gives states1 broad authority to set program eligibility criteria and to decide what HIVrelated treatments to include on ADAP formularies. For many people with HIV, ADAPs serve as a gateway to a broad array of healthcare and supportive services funded through the CARE Act and to other sources of coverage including Medicaid, Medicare, and private insurance. Since 1996, Congress has earmarked funds under Title II of the CARE Act specifically for ADAPs. Many states also provide state resources to ADAPs. All 50 states, the District of Columbia, Guam, Puerto Rico, and the Virgin Islands currently operate ADAPs.2

The National ADAP Monitoring Project The Henry J. Kaiser Family Foundation (KFF) commissions the National ADAP Monitoring Project, which is conducted in partnership with the National Alliance of State and Territorial AIDS Directors (NASTAD) and the AIDS Treatment Data Network (ATDN). The Project seeks to provide timely information on the current status of state and territorial ADAPs, trends over time, and key issues that impact ADAPs and their ability to provide medications to people living with HIV/AIDS. The National ADAP Survey, conducted by NASTAD and ATDN, serves as the basis for the Project’s Annual Report. The survey, sent to all state and territorial ADAP directors, includes questions on budgets, expenditures, client utilization, client demographics, eligibility criteria, and formularies from June of each year. The resulting data create a snapshot of ADAPs that can be compared over time. The Project’s Annual Report is released in the spring of each year.

The National ADAP Monitoring Project Annual Report, 2002 This report represents the sixth annual report released by the National ADAP Monitoring Project and is based on data from June 2001, unless otherwise indicated. All 54 state and territorial ADAPs responded to the 2001 survey. Due to differences in data collection among states and territories, some ADAPs do not answer all survey questions. Where trend data are presented, only states that provided relevant data in all periods are included. Every effort has been made to ensure that the annual report represents the current status of ADAPs as reported by survey respondents; however, some data may have changed between collection and this report’s release.

1

The term “state” is used generically in this report to include both states and territories.

2

The Federated states of Micronesia and the Marshall Islands, two Pacific U.S. territories, will receive federal ADAP earmark funding for the first time in FY 2002.

National ADAP Monitoring Project: Annual Report April 2002

TABLE OF CONTENTS 5

Executive Summary Introduction

5

National ADAP Trends & Key Themes Detailed Findings from the Current Survey

6

State-by-State Summary ADAP Profile

9

States/Territories with Current or Planned Program Restrictions, February 2002

11

State/Territorial ADAP Coverage of Recommended Drugs to Prevent Opportunistic Infections, 2001

12

Charts

15

Conclusion

37

Appendices

43

Appendix I:

Total Clients Served, Expenditures and Prescriptions Filled in June 2000 and June 2001

Appendix II:

ADAP Expenditures, by Class, June 2001

Appendix III:

Prescriptions Filled, by Class, June 2001

Appendix IV:

Race/Ethnicity of June 2001 ADAP Clients

Appendix V:

Gender and Age of June 2001 ADAP Clients

Appendix VI:

Income Level and Insurance Status of June 2001 ADAP Clients

Appendix VII:

Health Status of ADAP Clients Enrolled During 12-Month Period, FY 2001

Appendix VIII: ADAP Budget FY 2001: Federal and State Sources Appendix IX:

ADAP Budgets for FY 2000 and FY 2001: Total Federal and State

Appendix X:

Major FY 2001 Budget Categories Compared with FY 2000

Appendix XI:

ADAP Formularies by State/Territory

Executive Summary

Executive Summary Introduction

introduced new budget pressures for states, including for state Medicaid programs, the largest public payers of HIV/AIDS care, which in turn could affect demand on and resources for ADAPs. In addition to fiscal changes, the HIV-related treatment environment is increasingly complex, raising new challenges for ADAPs over time.

Spending on prescription drugs is one of the fastest growing segments of overall health care spending.1,2 Spending on HIV-related drugs is no exception. Combination antiretroviral therapy and medications for the prevention and treatment of HIV-related opportunistic infections are critical for HIV-infected individuals to achieve positive health outcomes. Yet HIV drugs are expensive, costing between $10,000 and $12,000 per year.3 Newer, more expensive drugs and the use of additional drugs to boost effectiveness or as “salvage” therapy may drive costs even higher.4 The expense of HIV drugs creates a significant barrier for HIV-positive individuals who do not have access to private or public insurance or whose insurance does not sufficiently cover costs associated with prescription medications.5 AIDS Drug Assistance Programs (ADAPs) provide FDA approved HIV-related prescription drugs to underinsured and uninsured individuals living with HIV/AIDS in all 50 states, the District of Columbia, Guam, Puerto Rico, and the Virgin Islands.6 As such, ADAPs—estimated to have served close to 140,000 clients in 2001,7 including almost 77,000 clients in the month of June 2001 alone—play a vital role in the healthcare of many HIV infected individuals.

National ADAP Trends & Key Themes The National ADAP Monitoring Project began tracking state and territorial ADAPs in 1996, at a time of tremendous change in the treatment of HIV/AIDS. The introduction of the first protease inhibitors and a move toward combination therapy at the end of 1995/beginning of 1996 represented a dramatic technological shift that greatly impacted ADAPs. Combination therapy became the first therapy to produce remarkable benefits to those living with HIV/AIDS, greatly increasing both length and quality of life. With the promise of new therapies, many people sought testing and treatment for the first time, causing ADAP enrollment to jump 23% in the last 6 months of 1996 alone, with some ADAPs experiencing increases of 50% or more during that period. National ADAP expenditures increased by 37% during the last six months of 1996 as well.

ADAPs operate within a dynamic environment, amid a variety of public and private insurance and care programs that provide prescription medications. Like all Ryan White CARE Act programs, ADAPs serve as payer of last resort, when no other safety-net program can provide the necessary drugs for those infected. ADAPs are not entitlement programs; annual federal, and in some cases state, appropriations determine how many clients ADAPs can serve and the level of services they can provide. In addition, the CARE Act gives states broad authority to set program eligibility criteria and to decide what HIV-related treatments to include on ADAP formularies, decisions that are often dictated by the availability of ADAP resources. Finally, health care system capacity and the availability of other programs within a given jurisdiction affect the ability of ADAPs to fill the gaps in prescription drug coverage. As a result, ADAPs are vulnerable to changes that impact fiscal priorities and to changes in other healthcare programs. Indeed, the recent economic downturn has

To meet this challenge, Congress appropriated supplemental funding for ADAPs in late 1996, leading to an increase of 97% ($182 million) in the national ADAP budget from FY 1996 to FY 1997 alone. Since that time, national ADAP trends have remained relatively constant over time, with ADAP client utilization, expenditures, and budgets growing but at slower rates, although individual states have experienced change at different rates. Analysis of data from 1996 through 2001, collected by the National ADAP Monitoring Project, highlights several major trends and key themes over time, including: • The demographic makeup of ADAP clients has remained fairly constant over the past several years. ADAPs continue to serve primarily people of color— although whites comprise the single largest demographic group. Most ADAP clients continue to

5

• Finally, all states take advantage of the most costeffective drug discount mechanisms available to their ADAPs—primarily the 340B Drug Discount Program. Given the rapidly rising costs of prescription drugs, however, many states are continuing to explore other options to obtain more significant drug discounts/rebates on state-purchased pharmaceuticals.

be low-income and uninsured, and most are men. • The number of clients served and the monthly program expenditures of state and territorial ADAPs have continued to grow over time, although at slower rates. Expenditure growth outpaced the growth in client utilization between 1996 and 2001. During this period, ADAP client utilization increased by 144%; ADAP monthly drug expenditures increased by 320%. Growth in the number of clients may reflect several factors including: increases in the number of people living with HIV/AIDS; increasing client demand; and increases in funding for ADAPs, enabling them to serve more people. Expenditure growth is attributable to several factors including: increases in client utilization; rising drug prices; and the increasing complexity of treatment regimens.

Detailed Findings from the Current Survey In addition to these overall themes, findings from the most recent survey period of June 2001 include: Clients, Expenditures, and Prescriptions • The number of clients served by ADAPs grew to 76,743 in June 2001. The overall growth rate for ADAPs reporting complete client and expenditure data between 1996 and 2001, the entire period of the National ADAP Monitoring Project, was 144%, including a 10% increase over the last year alone, a rate of growth smaller than in prior periods (see Charts 1 and 3).

• The national ADAP budget has also continued to grow over time, although, like clients and expenditures, at slower rates. Between FY 1996 and FY 2001, the national ADAP budget increased by 329%. The federal ADAP earmark continues to represent the core of the national ADAP budget. Slightly more than two-thirds of states provide state general revenue funds to their ADAP programs. In the remaining states, ADAPs must rely solely on federal funding.

• ADAP drug expenditures grew to almost $64 million in June 2001. The overall expenditure growth rate for ADAPs reporting complete client and expenditure data between 1996 and 2001 was 320%, including a 16% increase in the last year. Antiretrovirals continue to represent the bulk of drug expenditures (87%) (see Charts 2, 4, and 6).

• Despite the overall growth in the national ADAP budget, access to ADAPs continues to vary greatly depending upon where one lives, as indicated by wide variations in income eligibility criteria and formulary coverage across states, and the continued use of waiting lists and other access restrictions by some jurisdictions. Variations in access are the result of both the availability of other resources—and therefore the size of the gap that ADAPs are asked to fill—as well as state discretion over ADAP program design.

• Per capita drug expenditures were $831 in June 2001 (see Chart 5). • State ADAPs filled a total of 246,062 prescriptions in June 2001 (see Chart 7). ADAP Client Demographics • The demographic makeup of ADAP clients has remained fairly constant since 1996. The majority of ADAP clients in June 2001 were people of color, with African Americans representing approximately onethird (34%) and Hispanics representing about onequarter (24%) of the national ADAP population. Asian/Pacific Islanders and American Indians/Alaska Natives accounted for less than 1% each. White nonHispanics represented 38% of ADAP clients in June 2001 (see Chart 8).

• While different states have faced restrictions over time, a subset repeatedly struggles with lower ADAP income eligibility, more limited formularies, and other program restrictions. In at least four of the last six fiscal years (FY 1996–2001), the following 13 states—primarily southeastern and frontier states— have capped/limited client enrollment and/or restricted access to antiretrovirals: Alabama, Arkansas, Georgia, Idaho, Kentucky, Maine, Montana, North Carolina, Oklahoma, South Carolina, South Dakota, Texas, and Wyoming.

• Eight in ten (80%) ADAP clients in June 2001 were men, and almost all (99%) ADAP clients were over the age of 18 (see Chart 9).

6

in four of the last six fiscal years.10 The three states reporting capped or restricted access to antiretroviral drugs were Maine, Texas and Guam.

• ADAPs continue to serve a low-income population, with almost 80% of June 2001 ADAP clients reporting incomes at or below 200% of FPL,8 including slightly less than half (44%) reporting incomes less than 100% FPL (see Chart 10).

• The state ADAPs that consistently report program restrictions such as limited formularies, low financial eligibility criteria and/or additional clinical eligibility criteria, confront unique state level concerns that prevent ADAP expansion. Common issues include few state resources to direct toward ADAP, relatively less generous Medicaid programs and no state indigent/uninsured care program. In some jurisdictions, the state legislative body must approve various aspects of ADAP expansion.

• The majority of ADAP clients are uninsured. Six percent of June 2001 ADAP clients were reported to have Medicaid coverage and 10% percent were reported to have Medicare coverage (the number of dually covered among this group is unknown). Eleven percent of clients were reported to have some level of private insurance coverage (see Chart 11). The National ADAP Budget • The national ADAP budget grew to $810 M in FY 2001, an increase of approximately $86 million over FY 2000. The national ADAP budget has increased by 329% since FY 1996, including a 12% increase since last year, compared to a 9% increase over the prior reporting period (see Chart 14).

Client Eligibility Criteria and State Formularies • Financial eligibility for ADAPs ranged from a low of 125% FPL in North Carolina to a high of 500% FPL or more in Massachusetts, New Jersey, and New York. In addition to financial eligibility requirements, seven states reported additional clinical criteria for clients to access ADAP (e.g., specific CD4 or viral load ranges). Some ADAPs have implemented additional clinical criteria specifically for access to antiretroviral drugs (see State-by-State Summary ADAP Profile).

• The core of the national ADAP budget continues to be federal ADAP funding allocated under Title II of the Ryan White CARE Act (the ADAP earmark). The federal ADAP earmark accounted for nearly threequarters of the national ADAP budget in FY2001 (see Chart 15).

• ADAP formularies ranged from a low of 18 drugs covered in two states, Louisiana and Utah, to 471 drugs covered in New York. Two state ADAPs, Massachusetts and New Jersey, moved to an open formulary11 since the previous National ADAP Monitoring Project report (see Appendix XI).

• Much of the national ADAP budget increase in FY 2001 was due to increases in Title I Eligible Metropolitan Area (EMA) contributions9 and state general revenue funding of ADAP (see Charts 18 and 19). Eight ADAPs received contributions from Title I EMAs within their jurisdictions compared to 9 in FY 2000, although the dollar amount was higher in FY 2001. Thirty-eight states provided state general revenue support to ADAPs in FY 2001, compared to 37 in FY 2000 (see Appendix X). Funding from these sources has been highly variable due to other factors such as needs within the Title I EMA and state budget fiscal constraints.

• Almost all state ADAPs cover all FDA-approved antiretrovirals. South Dakota continues to be the only ADAP that does not provide coverage for protease inhibitors due to lack of resources. Coverage of drugs to prevent and treat opportunistic infections is increasing, but remains uneven. Ten states currently offer all 16 highly recommended drugs for the prevention and treatment of opportunistic infections according to Public Health Service/Infectious Disease Society of America (PHS/IDSA) Guidelines, up from 8 last year.12 A total of 36 states now cover 10 or more of these recommended OI drugs, up from 31 states last year. Only 2 states do not cover any of the recommended OI drugs, compared to 4 last year (see State-by-State Summary ADAP Profile).

ADAP Restrictions • Ten states/territories—Alabama, Georgia, Idaho, Kentucky, Maine, North Carolina, South Dakota, Texas, Wyoming, and Guam—reported having one or more program restrictions such as capped enrollment, limited antiretroviral access, and expenditure caps in response to fiscal constraints, as of February 2002 (see State-by-State Summary ADAP Profile). All of these states, except Guam, have reported restrictions

Other Issues Last year’s report identified several issues that could

7

affect state ADAPs over the coming years, each of which was assessed by the current survey:

provision of supplemental grants to states with severe ADAP needs.14 While this “ADAP supplemental” has begun to help some states expand their programs and ease restrictions, a core group of states continues to have limited or restricted programs. The continued program restrictions and limitations in these states may be indicative of less generous Medicaid programs or lack of other indigent care programs.

• New antiretroviral treatment guidelines released last year, suggesting delaying the initiation of antiretroviral therapy until later in illness.13 State ADAP programs reported that this clinical change has yet to have a significant impact on ADAPs given that ADAP clients generally enter the program late in disease progression, with very low CD4 counts, at which point, antiretroviral therapy would generally be indicated.

The State-by-State ADAP Summary Profile that begins on the next page provides a synopsis of each ADAPs eligibility criteria, coverage of specific drug classes, budget information, client utilization and expenditures, and reported program limitations/restrictions that were in place as of February 2002. Maps showing current or planned program restrictions and coverage of OI drugs across the country are also presented. These are followed by charts showing current data and trends over time. Detailed tables with data by state are contained in the Appendices.

• Ryan White CARE Act Amendments of 2001 (reauthorizing the CARE Act). The CARE Act Amendments contained provisions allowing ADAPs more flexibility, such as allowing ADAP funds to be used for medical monitoring and adherence programs. Many states reported, however, that the demand for medications prevented them from taking advantage of this flexibility over the last year. More importantly, the reauthorized CARE Act also allowed for the

1 Kaiser Family Foundation, Prescription Drug Trends: A Chartbook Update, November 2001.

9 Under the Ryan White CARE Act, an EMA’s Ryan White HIV Services Planning Council can decide to allocate Title I dollars to their state ADAP program.

2 Steinbrook, R., “The Prescription Drug Problem,” New England Journal of Medicine, Vol. 346, No. 11, March 2002.

10 This was the first year in which Guam provided data for the National ADAP Monitoring Project.

3 Health Resources and Services Administration, The ADAP Manual: AIDS Drug Assistance Program of the Ryan White CARE Act, 1999.

11 An open formulary provides access to any FDA-approved HIVrelated prescription drug.

4 A regimen used after a person develops resistance to the majority of available therapies is sometimes referred to as “salvage” therapy. These therapies often involve four or more drugs.

12 USPHS/IDSA, Guidelines for the Prevention of Opportunistic Infections in Persons Infected with Human Immunodeficiency Virus, November 2001. Available: www.hivatis.org/guidelines/ other/OIs/OIGNov27.pdf.

5 Kaiser Family Foundation, Financing HIV/AIDS Care: A Quilt with Many Holes, October 2000.

13 Department of Health and Human Services/The Henry J. Kaiser Family Foundation, Guidelines for the Use of Antiretroviral Agents in HIV infected Adults and Adolescents, February 2002. Available: www.hivatis.org/trtgdlns.html#Adult.

6 The Federated states of Micronesia and the Marshall Islands, two Pacific U.S. territories, will receive federal ADAP earmark funding for the first time in FY 2002.

14 Three percent of the ADAP earmark is set aside for supplemental grants to states with severe needs such as low financial eligibility, program restrictions, or limited formularies. These grants were first issued in FY 2001.

7 Health Resources and Services Administration, ADAP Fact Sheet. Available: www.hab.hrsa.gov/programs/factsheets/ adap1.htm. 8 In 2001, the FPL was $8,590 per year (slightly higher in Alaska and Hawaii) for a household of 1.

8

9

In 2001, the FPL was $8,590 per year (slightly higher in Alaska and Hawaii) for a household of 1. Refers to additional medical criteria to access ADAP such as a specified CD4 count, viral load, or both. All states require individuals to be HIV positive to access ADAP. 3 Additional medical criteria applies to ARV drug access only. 4 Virginia financial eligibility at 333% FPL for Northern Virginia only. 5 MA and NJ have an open formulary; see formulary for specific exclusions. 6 The following classes of drugs are covered as groups: Antidepressants, Antilipidemia, Bipolar Medications, Oral Analgesics, Oral Antidiabetics, Topical Steroids. Bold indicates changes from the 2000 survey reported in the 2001 survey. Italics indicate data from the 2000 survey. Shaded areas indicate restrictions lifted since 2000 survey.

2

1

State-by-State Summary ADAP Profile

10

In 2001, the FPL was $8,590 per year (slightly higher in Alaska and Hawaii) for a household of 1. Refers to additional medical criteria to access ADAP such as a specified CD4 count, viral load, or both. All states require individuals to be HIV positive to access ADAP. 3 Additional medical criteria applies to ARV drug access only. 4 Virginia financial eligibility at 333% FPL for Northern Virginia only. 5 MA and NJ have an open formulary; see formulary for specific exclusions. 6 The following classes of drugs are covered as groups: Antidepressants, Antilipidemia, Bipolar Medications, Oral Analgesics, Oral Antidiabetics, Topical Steroids. Bold indicates changes from the 2000 survey reported in the 2001 survey. Italics indicate data from the 2000 survey. Shaded areas indicate restrictions lifted since 2000 survey.

2

1

State-by-State Summary ADAP Profile

11

AK

ID

AZ

UT CO

NM

WY

MT

HI

TX

SD

ND

OK OK

MN

LA

AR

MO

WI

State has no current restrictions but may implement restrictions in FY 02.

State has current program restrictions and may implement additional restrictions in FY 02.

State currently has program restrictions in place (as of 2/02).

CA

OR

WA

IN KY

OH

GA

San German

Yauco Ensenada

Ponce Santa Isabel

Coamo

Arecibo Quebradillas Barceloneta Aguadilla Bayamon Centro Puntas San Sebastian Corozal Utuado Mayaguez Castaner OrocovisComerio

Guayama

Maunabo

Maguabo

Loiza Aldea

San Juan Cayey

NH

NY

NC

VA

SC

WV

PA

Puerto Rico

AL

TN

MS

IL

MI

VT

States/Territories with Current or Planned Program Restrictions, February 2002

DE MD

NJ

Agana

Guam

DC

MA

Umatac

Camp Quezon Ylig

Upi Asatdas

St. Martin

Virgin Gorda

Sombrero

Anegada

St. Eustatius

St. John

Tortola

St. Croix

St. Thomas

Barbuda

Nevis

Saint Johns

Basse-terre

St. Kitts

St. Barthelemy

Virgin Islands

Agat

Camp Bright

CT

ME

Antigua

12

ID

AZ

UT CO

HI

NM

WY

MT

TX

SD

ND

OK OK

MN

*IDSA/PHS Highly Recommended Drugs to Prevent Opportunistic Infections in People with HIV

Less than 10 OI Drugs Covered (18 jurisdictions).

WI

LA

AR

MO

10 or more Recommended OI Drugs Covered (36 jurisdictions including those that cover all 16).

All 16 Recommended OI Drugs Covered (11 jurisdictions).

AK

CA

OR

WA

IN KY

GA

Yauco Ensenada

Ponce Santa Isabel

Coamo

Guayama

Cayey

Maguabo Maunabo

San Juan

Loiza Aldea

NC

VA

SC

WV

Arecibo Barceloneta Bayamon San Sebastian Corozal Utuado Mayaguez Castaner OrocovisComerio Quebradillas

San German

Centro Puntas

OH

PA

Puerto Rico

AL

TN

MS

IL

MI

NY

VT

NH

State/Territorial ADAP Coverage of Recommended Drugs* to Prevent Opportunistic Infections, 2001

DE MD

NJ

CT

Camp Quezon Ylig Umatac Inarajan

Upi Asatdas

Anegada

St. Martin St. Eustatius

St. John

Virgin Gorda

Sombrero

Barbuda

Nevis

Saint Johns

Basse-terre

St. Kitts

St. Barthelemy

Virgin Islands Tortola

St. Croix

St. Thomas

Virgin Islands

Camp Bright Agat

Agana

Guam

DC

MA

ME

Antigua

Charts

Chart 1 ADAP Clients Served and Top Ten States, by Clients Served, June 2001 Number 80,000 70,000 60,000 50,000 40,000 30,000 20,000 10,000 0

State/Territory

76,743

June 2001 Clients

1 2 3 4 5 6 7 8 9 10

California Florida New York Texas Georgia New Jersey Puerto Rico Illinois Pennsylvania Virginia

Number of Clients June 2001 13,641 12,987 11,824 5,513 3,230 2,845 2,798 2,486 2,143 1,485

Note: Includes all 50 states, the District of Columbia, Guam, Puerto Rico, and the Virgin Islands.

n June 2001, ADAPs served 76,743 clients nationally. Ten states accounted for more than three quarters (77%) of all clients served in June 2001, with 5 states accounting for 61% of all clients. In general, these states represent the states with the highest AIDS prevalence (see Appendix I).

I

15

Chart 2 ADAP Drug Expenditures and Top Ten States, by Expenditures, June 2001

$70,000,000 $60,000,000 $50,000,000 $40,000,000 $30,000,000 $20,000,000 $10,000,000

State/Territory

$63,789,458

$0 June 2001 Expenditures

1 2 3 4 5 6 7 8 9 10

California New York Florida Texas New Jersey Georgia Puerto Rico Pennsylvania North Carolina Illinois

Expenditures, June 2001 $13,959,151 $13,530,163 $4,837,867 $3,791,192 $2,862,398 $2,637,349 $2,179,291 $1,964,109 $1,807,633 $1,753,051

Note: Includes all 50 states, the District of Columbia, Guam, Puerto Rico, and the Virgin Islands.

ational ADAP monthly drug expenditures totaled $63,789,458 in June 2001. As with clients served, 10 states accounted for 77% of June 2001 drug expenditures and 5 states accounted for 61% of drug expenditures (see Appendix I).

N

16

Chart 3 Trends in ADAP Client Utilization, 1996–2001 Number 80,000 70,000 60,000 50,000 40,000 30,000 20,000 10,000 0

144% 11%

10%

17% 22% 40%

June–96

June–97 June–98 June–99 June–00

June–01

Note: District of Columbia, Georgia, Guam, Louisiana, Missouri, New Mexico, North Dakota, Puerto Rico, Tennessee, Virgin Islands, and Wyoming not included.

he National ADAP Monitoring Project has been collecting data from state ADAPs since 1996. A majority of ADAPs (43) have provided client utilization and expenditure data over this period, and therefore offer an important window into trends over time. The number of clients served by ADAPs continues to grow over time, but at a decreasing rate. Between 1996 and 2001, ADAP client utilization increased by 144%, including a 10% increase in the last year alone. This compares to a 40% increase between 1996 and 1997. Growth in the number of clients may reflect several factors including: increases in the number of people living with HIV/AIDS; increasing client demand due to the availability of more effective therapies and/or state ADAP program client outreach efforts; and increases in funding available to ADAPs, enabling them to serve more people over time.

T

17

Chart 4 Trends in ADAP Drug Expenditures, 1996–2001 320%

Millions of Dollars

$60

16%

$50

23%

$40 $30

12%

37% 93%

$20 $10 $0

June–96 June–97 June–98 June–99 June–00 June–01

Note: District of Columbia, Georgia, Guam, Louisiana, Missouri, New Mexico, North Dakota, Puerto Rico, Tennessee, Virgin Islands, and Wyoming not included.

onthly ADAP drug expenditures have also increased over the past several years and at a faster rate than client growth. Between 1996 and 2001, expenditures grew by 320%, including a 16% increase in the last year alone. As with client utilization, the rate of expenditure growth has decreased over time. Expenditure growth is driven by several factors including: increases in the number of clients served; rising drug prices; and the increasing complexity of treatment regimens (e.g., moving from 2 to 3, to even 5 or more drugs used in combination).

M

18

Chart 5 Per Capita Spending, June 2001 OI/All Other $107 (13%)

ARV $724 (87%) Total Per Capita Spending= $831

Note: Guam not included.

ationally, in June 2001, ADAPs spent an average of $831 per client served, with about seven out of every eight dollars being spent on antiretrovirals ($724). The remainder (13% or $107) was spent per client on all other drugs, including drugs for the prevention and treatment of opportunistic infections (OIs).

N

19

Chart 6 ADAP Drug Expenditures, by Class, June 2001 OI/All Other 8% “A1” OI 5%

PI 29%

NNRTI 12% NRTI 46%

Total = $63,789,458 Note: Connecticut, Guam, Maine, and Massachusetts not included.

n June 2001, fifty states, representing 98% of total ADAP drug expenditures, were able to provide expenditure data for all drug classes, including the 16 “A1” opportunistic infection drugs recommended by the Infectious Disease Society of America/Public Health Service. Spending breakdowns were similar to last year’s National ADAP Monitoring Report. Antiretrovirals continue to account for the bulk of ADAP drug expenditures (87%). Among the three classes of approved antiretroviral drugs—nucleoside reverse transcriptase inhibitors (NRTIs), protease inhibitors (PIs), and non-nucleoside reverse transcriptase inhibitors (NNRTIs)—NRTIs account for almost half of ADAP drug expenditures (46%), followed by PIs (29%), and NNRTIs (12%). All other drugs, including drugs that prevent and treat opportunistic infections, account for 13% of drug spending. The 16 “A1” OI drugs alone accounted for 5% spent of total drug spending (see Appendix II).

I

The 16 “A1” drugs as recommended by the Infectious Disease Society of American/Public Health Service, Guidelines for the Prevention of Opportunistic Infections in Persons Infected with Human Immunodeficiency Virus, November 2001 include: acyclovir (Zovirax), azithromycin (Zithromax), cidofovir (Vistide), clarithromycin (Biaxin), famciclovir (Famvir), fluconazole (Diflucan), foscarnet (Foscavir), ganciclovir (Cytovene), isoniazid (INH), itraconazole (Sporonox), leucovorin, pyrazinamide, pyrimethamine (Daraprim, Fansidar), rifampin, sulfadiazine, and TMP/SMX (Bactrim).

20

Chart 7 ADAP Prescriptions Filled, by Class, June 2001 OI/All Other 26%

NRTI 36%

“A1” OI 11% NNRTI 10%

PI 17% Total = 246,062 Note: Connecticut, Florida, Georgia, Guam, Maine, and Massachusetts not included.

tates filled a total of 246,062 prescriptions in June 2001—up 19% compared to June 2000. Forty-eight states, representing 92% of total prescriptions filled in June 2001, were able to provide data on prescriptions filled by class. As with expenditures by class, prescriptions for ARVs represent the majority of all prescriptions filled (63%), although ARVs represent a smaller proportion of prescriptions filled than of total drug expenditures (see Chart 6). Prescriptions for all other drugs, including OI drugs, represented 37%, including 11% represented by category “AI” OI drugs. The percentage of prescriptions filled for NRTIs decreased by 3% compared to June 2000, while the percentage of NNRTIs remained the same (10%). Prescriptions for PIs remained relatively constant, and the number of OI prescriptions filled increased by 5% (see Appendix III).

S

21

Chart 8 ADAP Clients, by Race/Ethnicity, June 2001

Asian/PI 500 (not AIDS nor symptomatic HIV)—client whose CD4 count is above 500 and is not symptomatic nor has an AIDS diagnosis.

26

Chart 13 State Coverage of Resistance Testing,* FY 2001 Yes 35%

No 65%

The 19 states are: Alaska, California, Connecticut, Delaware, Florida, Georgia, Louisiana, Maryland, Massachusetts, Montana, New York, Ohio Oregon, South Carolina, South Dakota, Tennessee, Virginia, Washington, and the Virgin Islands. *Resistance testing can show whether a person’s virus is likely to be suppressed by each anti-HIV drug. There are two different types of resistance tests: Genotypic tests look for genetic mutations that have been linked to drug resistance; Phenotypic tests assess how much of a drug is required to block viral activity.

or the first time, jurisdictions were asked if their state/territorial AIDS program—the entity in state health departments that manages all state-level HIV/AIDS prevention and care programs, including ADAPs— provided funding (federal or state) to cover genotypic and phenotypic testing.* As genotypic and phenotypic testing become more integrated into practice, ADAPs and other programs that serve uninsured and underinsured individuals with HIV must determine how to pay for them. Nineteen states (35%) reported that their state AIDS program provides funding for resistance testing. Of the 19 states, 15 reported covering both genotypic and phenotypic, and 4 reported covering genotypic testing only (Georgia, Tennesse, Washington, and the Virgin Islands). These data, however, may provide an incomplete picture of statewide coverage for resistance testing, since individuals may also access resistance-testing services through agencies/programs funded primarily through other components of the Ryan White CARE Act (e.g., Titles I and III).

F

27

Millions of Dollars

Chart 14 The National ADAP Budget, FY 1996–2001 $900 $800 $700 $600 $500 $400 $300 $200 $100 $0

$810.2 $665.5

$724.5

$510.0 $370.8 $188.5

1996

1997

1998

1999

2000

2001

Milions of Dollars

National ADAP Budget, Rate of Growth in Dollars and Percent, FY 1996–2001 $200 $180 $160 $140 $120 $100 $80 $60 $40 $20 $0

120%

$182.3 $155.5 97%

100%

$139.2

80% $85.7 $59.0 38%

60% 40%

30%

9%

12%

98–99

99–00

00–01

20% 0%

96–97

97–98

Note: Bars on the National ADAP Budget Rate of Growth graph represent changes between the two years indicated, not aggregate changes since FY 1996.

he national ADAP budget grew to over $810 million in FY 2001, up from $188.5 million in FY 1996, representing a 329% increase. The ADAP budget represents combined funding from the Ryan White CARE Act (ADAP earmark, Title I, Title II and ADAP supplemental), state funding, and other federal funding (e.g., carry over from prior years).

T

In general, the national ADAP budget has been increasing but at a decreasing rate (similar to trends in client and expenditure growth). Between FY 1996 and FY 1997, for example, the budget increased by 97% ($182.3 million) compared to a 12% (or $85.7 million) increase between FY 2000 and FY 2001. For the first time over this period, however, the ADAP budget between FY 2000 and FY 2001 increased at a slightly greater rate than in the prior period (12% or $85.7 million compared to 9% or $59.0 million). Increases in funding from state sources and Title I EMAs drove much of the overall budget increase in FY 2001.

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Chart 15 National ADAP Budget, by Source, FY 2001

ADAP Supplemental $17,674,990 2%

Earmark $571,330,000 71%

Other Federal $17,617,447 2%

Title II Base $29,264,897 4% Title I $24,679,377 3%

State $149,635,427 18%

he federal ADAP earmark accounted for the largest proportion of the FY 2001 national ADAP budget, representing $571.3M or 71% of the total (compared to 73% in FY 2000). State contributions represented the second greatest budget category ($149.6M or 18%), similar to FY 2001. Funding from Title I EMAs increased to $24.7M or 3% of the budget, up only slightly from FY 2000 (2%), while contributions from the Title II base declined slightly as a percentage of the budget, from 5% in FY 2000 to 4% in FY 2001 ($29.3M). Funding from other federal sources represented $17.6M or 2% of the FY 2001 budget. The slight variations in proportional representation of budget categories reflect both the introduction of the ADAP supplemental and actual dollar changes in some categories.

T

FY 2001 was the first year for the ADAP supplemental grants authorized by the Ryan White Care Act Amendments of 2000 (which reauthorized the CARE Act). Three percent of ADAP earmark funds ($17.7 million in FY 2001) appropriated by Congress were set aside for grants to states with severe needs as indicated by such factors as financial eligibility set at or below 200% FPL, limited formularies, or program restrictions. Fourteen states received supplemental grants in FY 2001. Combined ADAP earmark and supplemental funding represents 73% of the national ADAP budget, the same proportion as the earmark in FY 2000, before the introduction of the ADAP supplemental. Most jurisdictions saw an increase in their overall ADAP budget between FY 2000 and FY 2001, although 6 states experienced decreases (see Appendix VIII).

29

Chart 16 The ADAP Earmark, FY 1996–2001 Millions in Dollars

$600

$527.6

$500

$571.3

$460.6

$400 $285.5

$300 $167.0

$200 $100 $0

$51.9 1996

1997

1998

1999

2000

2001

Millions in Dollars

The ADAP Earmark, Rate of Growth in Dollars and Percent, FY 1996–2001 $200 $180 $160 $140 $120 $100 $80 $60 $40 $20 $0

222%

250%

$175.1

200% $115.1

$118.5

71%

150% $67.0 61%

100% $43.7

15%

50% 8% 0%

96–97

97–98

98–99

99–00

00–01

Note: Bars on the ADAP Earmark Rate of Growth graph represent changes between the two years indicated, not aggregate changes since FY 1996.

he ADAP earmark represents money set aside in Title II of the CARE Act specifically to fund ADAPs. The ADAP earmark—the largest component of the national ADAP budget—grew to $571.3 million in FY 2001, representing a more than ten-fold increase since FY 1996, when the earmark totaled $51.9 million; most of the rate of growth occurred between FY 1996 and 1997. The rate of growth in the ADAP earmark has slowed over time—the earmark increased by 222% between FY 1996 and 1997 compared to a 15% increase between FY 1999 and 2000 and an 8% increase between FY 2000 and 2001.

T

Twenty-two states indicated they planned to use a total of about $15 million in federal ADAP earmark dollars to fund insurance maintenance programs (approximately 3% of the total ADAP earmark). Thirteen states noted their plans to use federal ADAP earmark funds for medical monitoring, adherence and outreach programs, but did not report total dollars amount. The ADAP supplemental grants, first implemented in FY 2001, served as one reason for the earmark decline, since money was set aside from the earmark for supplemental grants. Combining earmark and supplemental funds results in an increase of $61.4 million or 11% over last year. Over time, the federal ADAP earmark (including FY 2001 supplemental grant funding) has come to represent the core of the national ADAP budget, growing from 27% of the budget in FY 1996 to 73% in FY 2001.

30

Millions in Dollars

Chart 17 Title II Base Funding, FY 1996–2001 $80 $70 $60 $50 $40 $30 $20 $10 $0

$67.6

$71.9 $50.5

$50.1

$38.6 $29.3

1996

1997

1998

1999

2000

2001

Millions in Dollarss

Title II Base Contributions, Rate of Growth, in Dollars and Percent, FY 1996–2001 $20 $15 $10 $5 $0 -$5 -$10 -$15 -$20 -$25

$17.5 35%

$4.3 6% -24%

-$9.3

-30% -$11.9

-24%

99–00

00–01

-$21.4 96–97

97–98

98–99

40% 30% 20% 10% 0% -10% -20% -30% -40%

Note: Bars on the Title II Base Contributions Rate of Growth graph represent changes between the two years indicated, not aggregate changes since FY 1996.

tates can choose to use some of their Ryan White Title II Base funds for their ADAPs. Title II Base contributions to ADAPs have largely decreased over time. Contributions from the Title II Base decreased between FY 1996 and FY 2001 overall ($50.1 million compared to $29.3 million, a more than 40% decrease). Title II Base contributions decreased by 24% ($9.3 million) between FY 2000 and FY 2001, the same percentage decrease as between FY 1999 and FY 2000 (24% or $11.9 million). Title II Base funds for ADAPs represented only 4% of the national budget in FY 2001, compared to 27% in FY 1996. As noted previously by the National ADAP Monitoring Project, one reason for this continued decline may be that states have more flexibility with base funds to support other non-ADAP services such as primary care, mental health care, substance abuse treatment, and supportive services. In FY 2001, twenty-four states allocated Title II base funds to ADAP, up from 23 in FY 2000 (see Appendix X).

S

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Chart 18 Title I EMA Funding, FY 1996–2001 $30

$25.9

Millions in Dollars

$25

$24.3

$26.8

$24.7

$23.2

$20

$17.5

$15 $10 $5 $0 1996

1997

1998

1999

2000

2001

Title I EMA Funding, Growth Rate, in Dollars and Percent, FY 1996–2001

Millions in Dollars

$8 $6 $4 $2 $0 -$2 -$4 -$6 -$8

$2.5 -$1.6

10%

41%

50% 40%

$7.2

30% 20% 10% 0%

-$3.6

-6%

-10% -20% -30%

-$5.7 -13%

96–97

97–98

98–99

-25% 99–00

00–01

Note: Bars on the Title 1 EMA Funding Rate of Growth graph represent changes between the two years indicated, not aggregate changes since FY 1996.

ontributions to ADAP from Title I EMAs increased by 41% between FY 2000 and FY 2001, to reach a total of $24.7 million. This reverses the trend of falling Title I contributions, both in actual dollars and percent growth, since FY 1998. Title I contributions now make up 3% of the ADAP budget, up from 2% last year. While states make decisions regarding allocation of state general revenue funds and Title II base funds, Ryan White HIV Services Planning Councils make allocation decisions regarding Title I funds. Contributions from Title I funds must be spent to purchase medications for clients living within the Title I EMA. Twenty-seven states and Puerto Rico have a Title I EMA or a portion of a Tile I EMA in their jurisdiction. The District of Columbia is also a Title I EMA and includes portions of Maryland and Virginia. Eight ADAPs received contributions from Title I EMAs in FY 2001 compared to 9 in FY 2000 (see Appendix X).

C

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Millions of Dollars

Chart 19 State Funding, FY 1996–2001 $160 $140 $120 $100 $80 $60 $40 $20 $0

$149.6 $117.4

$119.4

$125.5

$128.8

1997

1998

1999

2000

$50.4

1996

2001

State Funding, Rate of Growth, in Dollars and Percent, FY 1996–2001

Millions of Dollars

$80 $70 $60 $50 $40 $30 $20 $10 $0

133%

140% 120% 100%

$67.0

80% 60% $20.8

96–97

$2.0

$6.1

$3.3

2% 97–98

5% 98–99

3% 99–00

40% 20%

16%

0%

00–01

Note: Bars on the State Funding Rate of Growth graph represent changes between the two years indicated, not aggregate changes since FY 1996.

tates can decide to allocate state general revenue funds to their ADAPs. State funding of ADAP increased by 16% between FY 2000 and FY 2001 to reach a total of $149.6 million. The national ADAP budget now consists of 18% state funding, consistent with FY 2000. Thirty-eight states contributed general revenue funds to ADAP in FY 2001, up from 37 in FY 2000 (see Appendix X).

S

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Chart 20 ADAP Cost Recovery Resources, FY 2001 Insurance Recovery 15%

Miscellaneous 5%

Drug Rebates 80%

Total = $4.1M

ost recovery represents reimbursement to ADAPs from other entities for medications purchased through the ADAP program. Overall, cost recovery represents $4.1 million to ADAPs. Drug rebates, including those that are voluntary, mandated by state law, or available to ADAPs as 340B entities, continue to make up the largest percent of ADAP cost recovery (80%). This does not include 340B discounts offered to direct purchase ADAPs, which are received at the time of purchase. Another recovery source continues to be insurance recovery (15%), where the ADAP receives reimbursement from insurance providers for medications purchased for their clients. Insurance providers include both private providers and public providers such as Medicaid. Miscellaneous recovery (5%) includes income received from various sources such as private contributions and corporate donations.

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Conclusion

Conclusion Serving almost 77,000 largely uninsured and low-income people with HIV/AIDS in June 2001, state and territorial ADAPs continue to play a critical role in the provision of medications to those who are uninsured and underinsured. ADAPs fill the gaps in prescription drug coverage and often serve as a bridge to comprehensive health care resources including other Ryan White-funded programs, Medicaid, and private insurance. After a major shock to the system in late 1995—with the introduction of protease inhibitors and combination therapy as the standard of care—trends in ADAP client, expenditure, and budget growth have remained relatively constant, as all three continue to grow but at slower rates.

• For the second year, President Bush has recommended flat funding for certain federal HIV/AIDS programs in his FY 2003 proposed budget, including the ADAP program. Last year, ADAP programs fared well during Congressional appropriations. Final appropriations for FY 2003 are not yet known. With federal dollars accounting for the core of the national ADAP budget, some states could be forced to further restrict access to ADAP programs. • The continuing increases in the price of medications coincide with federal and state fiscal concerns. The price of prescription drugs increased more than three times the rate of inflation between 1998 and 2000.4 While the federal drug discount program (the 340B Program) used by most ADAPs largely shields them from annual price increases greater than inflation, a drug company that has not increased prices for two or more quarters may include past inflationary increases in a single quarter increase.5 This recently occurred in the case of Sustiva, a popular non-nucleoside reverse transcriptase inhibitor (NNRTI) used in many protease-sparing regimens, whose price to ADAPs rose by 10%.6 Such a sudden increase makes it more difficult for ADAPs to budget effectively.

National ADAP budget growth, however, has not eliminated program restrictions and limitations in some states, and some states have experienced large fluctuations in client utilization, expenditures, and budgets over time. In addition, as discretionary programs that rely mainly on annual federal—and in some cases, state—appropriations, ADAPs’ continuing fiscal stability is subject to changes in federal and state political, economic, and social priorities. ADAPs often cannot predict whether they will face budget shortfalls until well into their fiscal year. While these overall trends are expected to continue, there are several factors and issues on the horizon that could affect the ability of ADAPs to meet increasing client demand over time. These factors include:

The Treatment/Technological Outlook • T-20, the first fusion inhibitor, could receive FDA approval prior to the end of 2002, marking the first dramatic technological change in HIV treatment since the introduction of protease inhibitors.7 Initial data on this drug indicate that it is highly effective, particularly when treating patients who have developed multiple drug resistance to the current drug classes. Beyond 2002, other fusion inhibitors besides T-20 will likely receive approval, in addition to another new class of drugs, integrase inhibitors, and new generations of existing classes, creating further shifts in highly active antiretroviral therapy (HAART).8 The impact of these changes on ADAP client utilization and drug expenditures remains unclear.

The Fiscal Outlook • The Office of Management and Budget (OMB) is predicting a federal deficit that will reach over $106 billion in FY 2002 and over $80 billion in FY 2003.1,2 This economic downturn has had a dramatic impact on states. The National Association of State Budget Officers (NASBO) and the National Governors Association (NGA) report that total state deficits reached $40 billion in FY 2001.3 Statutes in many states prohibit deficit spending, forcing these states to enact drastic budget cuts. At the same time, the costs involved in strengthening the public health system’s bioterrorism preparedness have become the focus of attention. Budget deficits and a focus on bioterrorism at both the federal and state level have already resulted in resource constraints.

• Structured intermittent therapy (SIT), consisting of defined periods on and then off treatment designed to ease the effects of HAART and potentially increase

37

adherence, is another shift. Initial studies indicate some promise to this strategy.9 The impact it may have on ADAP remains uncertain. SIT could potentially create cost savings, as clients no longer use medications on a continuous basis.

the cost to ADAPs of maintaining individuals on HAART. • Finally, drug resistance and resistance testing present ongoing challenges. As genotypic and phenotypic testing11 become more integrated into practice, ADAPs and other programs that serve uninsured and underinsured individuals with HIV must determine how to pay for them. Drug resistance presents another challenge in itself; as individuals become more resistant to medications it becomes more likely they will be on “salvage” therapy—regimens consisting of four or more drugs and sometimes more than one protease inhibitor to boost effectiveness. These factors have cost implications for ADAPs.

• Another concern facing ADAPs is the impact of hepatitis C co-infection. Up to 25% of HIV infected individuals are co-infected with HCV, the virus that causes the symptoms of hepatitis C.10 State and local health department resources and infrastructure to test for and treat HCV vary greatly among states. The cost of HCV treatment for co-infected individuals will likely fall to ADAPs since few HCV specific treatment programs exist at the federal or state level. ADAPs must also continue to make decisions regarding medications that treat the side effects of HAART, including adding statins that reduce cholesterol, blood pressure medications, and diabetes medications. All of these could lead to an increase in

ADAPs have always operated as part of a dynamic health care treatment and financing environment, subject to changes in both. The National ADAP Monitoring Project will continue to monitor the status of ADAPs and the factors identified above over the next year.

1 Office of Management and Budget, Historical Tables, Budget of the United States Government, Fiscal Year 2003, 2002. Available: www.whitehouse.gov/omb/budget/fy2003/budget.html.

7 Unlike current antiretrovirals, fusion inhibitors work to prevent HIV from entering a CD4 cell. 8 Integrase inhibitors interfere with the enzyme integrase that assists HIV in binding its genetic material with that of the CD4 cell.

2 The federal fiscal year runs from October 1st through September 30th. The ADAP fiscal year runs from April 1st through March 31st. State fiscal years will vary by state. Fiscal years referred to in this report are ADAP fiscal years unless otherwise noted.

9 Altfeld, M, Dybul, M, Miller, V, “An STI Confab: Insights Into Treatment Interruptions for Patients with Early, Chronic, and Drug Resistance HIV Disease,” Physicians Research Network/PRN Notebook, September 2001. Available: www.prn.org/prn_nb_cntnt/vol6/num3/sti_frm.htm.

3 The National Governors Association and The National Association of State Budget Officers (2001) The Fiscal Survey of States, 2001. Available: www.nasbo.org/Publications/ fiscsurv/fiscsurvdec2001.pdf.

10 Centers for Disease Control and Prevention, Frequently Asked Questions About Co-infections with HIV and Hepatitis C, August 2001.

4 Kaiser Family Foundation, Prescription Drug Trends: A Chartbook Update, November 2001. 5 For more information on the ADAP drug discount programs, see: Kaiser Family Foundation and the National Alliance of State and Territorial AIDS Directors, AIDS Drug Assistance Programs: Getting the Best Price, April 2002.

11 Resistance testing can show whether a person’s virus is likely to be suppressed by each anti-HIV drug. There are two different types of resistance tests: Genotypic tests look for genetic mutations that have been linked to drug resistance; Phenotypic tests assess how much of a drug is required to block viral activity.

6 Red Book, Thomson Medical Economics, 2001.

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Appendices

Appendix I

Total Clients Served, Expenditures and Prescriptions Filled in June 2000 and June 2001

43

NR indicates data not reported. NA indicates calculation not possible due to missing data. NC indicates not covered on ADAP formulary. National Comparison Totals are calculated based on those states that reported complete data in all three categories in both time periods.

Total Clients Served, Expenditures and Prescriptions Filled in June 2000 and June 2001

45

NR indicates data not reported. NA indicates calculation not possible due to missing data. NC indicates not covered on ADAP formulary. National Comparison Totals are calculated based on those states that reported complete data in all three categories in both time periods.

Total Clients Served, Expenditures and Prescriptions Filled in June 2000 and June 2001

Appendix II ADAP Expenditures, By Class, June 2001

49

R indicates data not reported. NA indicates calculation not possible due to missing data. NC indicates not covered on ADAP formulary. National Comparison Totals are calculated on those states that provided complete expenditure data for all classes.

ADAP Expenditures, By Class, June 2001

50

NR indicates data not reported. NA indicates calculation not possible due to missing data. NC indicates not covered on ADAP formulary. 1 Expenditures for A1 OI drugs reported with OI/All Other drugs for MA. 2MT covers a limited number of OI drugs but had no expenditures in June 2001. National Comparison Totals are calculated on those states that provided complete expenditure data for all classes.

ADAP Expenditures, By Class, June 2001

Appendix III

Prescriptions Filled, by Class, June 2001

53

NR indicates data not reported. NA indicates calculation not possible due to missing data. NC indicates not covered on ADAP formulary. National Comparison Totals are calculated on those states that provided prescription breakout data. 2MT ADAP covers a limited number of OI drugs but did not purchase any in June 2001.

Prescriptions Filled, by Class, June 2001

54

NR indicates data not reported. NA indicates calculation not possible due to missing data. NC indicates not covered on ADAP formulary. 1 Expenditures for A1 OI drugs reported with OI/All Other drugs for MA and ME. National Comparison Totals are calculated on those states that provided prescription breakout data. 2MT ADAP covers a limited number of OI drugs but did not purchase any in June 2001.

Prescriptions Filled, by Class, June 2001

Appendix IV

Race/Ethnicity of June 2001 ADAP Clients

Race/Ethnicity of June 2001 ADAP Clients

57

Appendix V Gender and Age of June 2001 ADAP Clients

Gender and Age of June 2001 ADAP Clients

61

Appendix VI

Income Level and Insurance Status of June 2001 ADAP Clients

65

A number of states were unable to provide data for all categories. These states are not included in the total percentage calculations.

Income Level and Insurance Status of June 2001 ADAP Clients

66

A number of states were unable to provide data for all categories. These states are not included in the total percentage calculations.

Income Level and Insurance Status of June 2001 ADAP Clients

Appendix VII

Health Status of ADAP Clients Enrolled During 12-Month Period, FY 2001

69

Data collected between 5/00–9/01, except Kansas (1/00–12/00), Oklahoma (4/01– 9/01), and Vermont (10/00–8/01). Some states requires annual re-enrollment, therefore chart does not reflect new clients exclusively. Some states unable to provide this data.

Health Status of ADAP Clients Enrolled During 12-Month Period, FY 2001

Appendix VIII

ADAP Budget FY 2001: Federal and State Sources

73

ADAP Budget FY 2001: Federal and State Sources

74

ADAP Budget FY 2001: Federal and State Sources

Appendix IX ADAP Budgets for FY 2000 and FY 2001: Total Federal and State

ADAP Budgets for FY 2000 and FY 2001: Total Federal and State

NR indicates data not reported. NA indicates calculation not possible due to missing data. NC indicates not covered on ADAP formulary. National Comparison Totals are calculated on those states that provided complete data in both time periods.

77

Appendix X Major FY 2001 Budget Categories Compared with FY 2000

81

Major FY 2001 Budget Categories Compared with FY 2000

82

ADAP Supplemental Grants were first awarded in FY 2001 and are therefore not included in this comparison. The "Other Federal" budget category, which includes carryover, varies greatly by state according to the states budgeting process and is therefore not included in this comparison.

Major FY 2001 Budget Categories Compared with FY 2000

Appendix XI ADAP Formularies by State/Territory

ADAP FORMULARIES Alabama

New drugs added since June 2000 indicated in bold.

ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), fluconazol (Difulcan), ganciclovir (Cytovene), lecovorin, sulfatrim DS (Bactrim, Septra). Other OIs- epoetin alfa (Procrit), dapsone, valganciclovir (Valcyte). Hepatitis C- none.

Alaska ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx, Videx EC), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), cidofovir (Vistide), clarithromycin (Biaxin), famciclovir (Famvir), fluconazole (Diflucan), foscarnet (Foscavir), ganciclovir (Cytovene), isoniazid (INH), itraconazole (Sporonox), leucovorin, pyrazinamide, pyrimethamine (Daraprim, Fansidar), rifampim, sulfadiazine, TMP/SMX (Bactrim) Other OIs- amphotericin B, atovaquone, ciprofloxacin, clindamycin, clotrimazole (Mycelex), dapsone, ethambutol, fomivirsen, ketoconazole, nystatin, pentamidine (aerolsolized), pyridoxine, rifabutin. Hepatitis C- none. TREATMENTS FOR METABOLIC DISORDERS Hyperlipidemia- atorvastatin calcium (Lipitor), gemfibrozil (Lopid), pravastatin sodium (Pravachol). Wasting- testosterone (depotest, patches and gel, oxandrin, deca-durabolin, or delatestry). ALL OTHERS diphenox/atr sulf (Lomotil), gabapentin (Neurontin), hepatitis A Vaccine (2 doses), hepatitis B Vaccine (3 doses), influenza (annually), loperamide (Imodium), pneumococcal Vaccine, prochlorperazine (Compazine), varicella zoster immune globulin.

Arizona ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx, Videx EC), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir, azithromycin (Zithromax), clarithromycin (Biaxin), pyrimethamine (Daraprim), TMP/SMX (Bactrim). Other OIs- dapsone, pentamidine (NebuPent), rifabutin (Mycobutin), trimethoprim. Hepatitis C- none.

Arkansas ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), clarithromycin (Biaxin), famciclovir (Famvir), fluconazole (Diflucan), itraconazole (Sporonox), leucovorin, pyrimethamine (Daraprim), sulfadiazine, TMP/SMX (Bactrim, Septra). Other OIs- amoxicillin/clavulanate (Augmentin), atovaquone (Mepron), cephalexin (Keflex), ciprofloxacin (Cipro), clindamycin (Cleocin), clofazimine (Lamprene), clotrimazole (Mycelex), dapsone, doxycycline, erythromycin, ethambutol (Myambutol), griseofulvin (Fulvicin), ketoconazole (Nizoral), metronidazole, nystatin, ofloxacin (Floxin), paromomycin (Humatin), terbenafine (Lamisil), valacyclovir (Valtrex). Hepatitis C- none.

ADAP FORMULARIES California ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx ,Videx EC), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), cidofovir (Vistide), clarithromycin (Biaxin), famciclovir (Famvir), fluconazole (Diflucan), foscarnet (Foscavir), ganciclovir (Cytovene), isoniazid (generic), itraconazole (Sporonox), leucovorin calcium (Wellcovorin), pyrazinamide (generic), pyrimethamine (Daraprim), rifampim (generic), sulfadiazine (oral generic), TMP/SMX (Bactrim, Septra). Other OIs- albendazole (Albenza), amikacin sulphate (generic injection), amoxicillin trihydrate (oral generic), amphotericin B (Fungizone), atovaquone (Mepron), bleomycin sulfate (Blenoxane), ciprofloxacin (Cipro), clindamycin (Cleocin), clofazimine (Lamprene), clotrimazole (Lotrimin, Mycelex), cyclophosphamide (Cytoxan), dapsone (Avlosulfon), dexamethasone (Decadron), doxorubicin (Adriamycin), epoetin alpha (Procrit), ethambutol (Myambutol), filgrastim (Neupogen), flucytosine (5FC, Ancobon), fomivirsen (Vitravene), ketoconazole (Nizoral), isoniazid/rifampin (generic), liposomal duanorubicin (DaunoXome), methotrexate (oral, injection), metronidazole (oral generic), nystatin (Mycostatin), paclitaxel (Taxol), paromomycin (Humatin), pentamidine (Nebupent, Pentam), prednisone (oral generic), rifabutin (Mycobutin), trimethoprim (Trimpex, Proloprim), trimetrexate glucuronate (NeuTrexin), valacyclovir (Valtrex), vinblastine sulfate (Velban), vincristine sulfate (Oncovin). Hepatitis C- interferon alfacon 1 (Infergen), interferon A-2A (Intron-A, Roferon-A), ribavirin (generic), ribavirin/interferon alpha 2B (Rebetron). TREATMENTS FOR METABOLIC DISORDERS Diabetic- glipizide (Glucotrol), rosiglitazone maleate (Avandia). Hyperlipidemia- atorvastatin (Lipitor), gemfibrozil (generic only), pravastatin (Pravachol), simvastatin (Zocor). Wasting- dronabinol (Marinol), megestrol acetate (Megace), nandrolone (Durabolin, Deca-Duranbolin), oxandrolone (Oxandrin), somatropin (Serostim), testosterone (generic injection, transdermal). ALL OTHERS alitretinoin gel (Panretin Gel), alprazolam (Xanax), amitriptyline hydrochloride (generic), bupropion HCL (Wellbutrin), buspiron HCL (BuSpar), cephalexin (oral generic), citalopram hydrobromide (Celexa), codeine w/wo ASA, APAP (oral generic), desipramine HCL (oral generic), dicloxacillin sodium (oral generic), diphenoxylate HCL (Lomotil), divalproex sodium (Depakote), doxycycline hyclate (oral generic), erythromycin (oral generic), famotidine (generic), fenoprofen calcium (oral generic), fentanyl (Duragesic, hospice clients only), fluoxetine HCL (Prozac), gabapentin (Neurontin), hepatitis A vaccine, hepatitis B vaccine, hydrocodone w/wo APAP (oral generic), ibuprofen-prescription strength (generic), imiquimod (Aldara), indomethacin (oral generic), ketoprofen (oral generic), ketorolac tromethamine (Toradol injection), lamotrigine (Lamictal), lansoprazole (Prevacid), levorphenol tartrate (Levo-Dromoran), loperamide HCL (generic), lorazepam (oral generic), methadone HCL (oral generic), metoclopramide (Reglan, Clopra), minocycline HCL (oral generic), morphine sulfate (oral generic), naproxen (oral generic), nefazodone HCL (Serzone), neomycin sulfate (oral generic), nortriptyline HCL (oral generic), olanzapine (Zyprexa), omeprazole (Prilosec), opium, tincture of, oxycodone w/wo ASA, APAP (oral generic), pancrelipase (Ultrase), paroxetine HCL (Paxil), penicillin V potassium (oral generic), pneumococcal vaccine (Pneumovax, Pnu-Immune), probenecid (generic), prochlorperazine (Compazine), promethazine (Phenergan), quetiapine fumarate (Seroquel), ranitidine HCL (prescription strength generic), risperidone (Risperdal), sertraline (Zoloft), sulindac (oral generic), tetracycline HCL (oral generic), trazodone HCL (oral generic), vancomycin HCL (oral generic), venlafaxine HCL (Effexor).

Colorado ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx, Videx EC), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), cidofovir (Vistide), clarithromycin (Biaxin), famciclovir (Famvir), fluconazole (Diflucan), foscarnet (Foscavir), ganciclovir (Cytovene), itraconazole (Sporonox), pyrimethamine (Daraprim), sulfadiazine, TMP/SMX (Bactrim,Septra). Other OIs- amphotericin (Fungizone), atovaquone (Mepron), clindamycin (Cleocin), clotrimazole (Mycelex), dapsone, ethambutol (Myambutol), pentamidine (Nebupent), rifabutin (Mycobutin), valacyclovir (Valtrex), valganciclovir (Valcyte). Hepatitis C- none.

ADAP FORMULARIES Connecticut ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin, clarithromycin (Biaxin), fluconazole (Diflucan), foscarnet (Foscavir), ganciclovir (Cytovene), itraconazole (Sporonox), leucovorin, pyrimethamine, sulfadiazine, TMP/SMX (Bactrim). Other OIs- amphotericin B (Fungizone B), atovaquone (Mepron), ciprofloxacin (Cipro), clindamycin (Cleocin), clotrimazole (Lotrimin, Mycelex), dapsone, erythropoietin (Epogen, Procrit), ethambutol (Myambutol), filgrastim (G-CSF, Neupogen), ketoconazole (Nizoral), metronidazole (Flagyl), nystatin, ofloxacin (Floxin), paromomycin (Humatin), pentamidine (Pentam 30, NebuPent), prednisone, primaquine, rifabutin (Mycobutin), terconazole (Terazol 3 & 7), trimethoprim (Proloprim), valcyclovir (Valtrex), valganciclovir (Valcyte). Hepatitis C- peg-interferon alfa-2b (PEG-Intron), ribavirin (Rebetol). TREATMENTS FOR METABOLIC DISORDERS Cardiac- atenolol (Tenormin), diltiazem HCL (Cardizem), hydrochlorothiazide (HCTZ), isosorbide mononitrate (Imdur), lisinopril (Prinivil, Zestril), nitroglycerin. Diabetic- glipizide (Glucotrol), insulin NPH, insulin regular. Hyperlipidemia- atorvastatin (Lipitor), fenofibrate (Tricor), gemfibrozil (Lopid), pravastatin (Pravachol). Wasting- dronabinol (Marinol), megestrol acetate (Megace), nandrolone deconoate (Deca-Duranbolin), oxandrolone (Oxandrin), oxymetholone (Anadrol-50), testosterone (Androgel), testosterone (Androderm), testosterone cypionate (Depo-Testosterone). ALL OTHERS alprazolam (Xanax), amitriptyline (Elavil), amoxicillin, amoxicillin/Pot. Clavulante (Augmentin), cefuroxime, cephalexin, chlorhexidine gluconate (Peridex), citalopram hydrobromide (Celexa), codeine phosphate/acetominophen, Comvax, dicloxacillin, diphenoxylate HCL (Lomotil, Lonox), doxycycline, Engerix-B, fentanyl patch (Duragesic), gabapentin (Neurontin), guaifenesin/pseudoephedrine (Entex PSE), Havrix, hydrocortisone (cream/lotion/ointment), hydroxyzine HCL (Atarax), lactic acid, lithium (Eskalith), loperamide HCL (Imodium), lorazepam (Generics only), monetasone furoate monohydrate (Nasonex), olanzapine (Zyprexa), oxycodone HCL controlled release (Oxycontin), paroxetine HCL (Paxil), pneumococcal vaccine, prochloparazine (Compazine), Recombivax HB, sertraline (Zoloft), triamcinolone (acetonide cream/ointment), Twinrix, vancomycin, Vaqta, venlaxifine HCL (Effexor).

ADAP FORMULARIES Delaware ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx, Videx EC), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), cidofovir (Vistide), clarithromycin (Biaxin), famciclovir (Famvir), fluconazole (Diflucan), foscarnet (Foscavir), ganciclovir (Cytovene), isoniazid (INH), itraconazole (Sporonox), leucovorin (Wellcovorin), pyrazinamide, pyrimethamine (Daraprim), rifampim, sulfadiazine (Microsulfon), TMP/SMX (Bactrim, Septra). Other OIs- atovaquone (Mepron), ciprofloxacin (Cipro), clindamycin (Cleocin), clotrimazole (Mycelex), clotrimazole vaginal (Gyne-Lortimin), dapsone (Avo-Sulfon), epoetin alfa (Procrit, Epo), ethambutol (Myambutol), filgrastim (Neupogen), ketoconazole (Nizoral), miconazole cream (Monistat), ofloxacin (Floxin), paromomycin (Humatin), pentamidine (Nebupent), prednisone (Deltasone), rifabutin (Mycobutin). Hepatitis C- interferon alfa-2a (Roferon A), interferon alfa-2b (Intron A), interferon alfacon-1 (Infergen), interferon alfa-2b + ribavirin (Rebetron), peg-interferon alfa-2b (PEG-Intron), ribavirin (Rebetol). TREATMENTS FOR METABOLIC DISORDERS Cardiac- isoproterenol (Isuprel), temazepam (Restoril). Diabetic- acarbose (Precose), clorpropamide (Diabinese), glimepiride (Amaryl), glipizide (Glucotrol), glyburide (Diabeta, Micronase), insulin (all types), metformin (Glucophage), pioglitazone (Actos), repaglinide (Prandin), rosiglitazone (Avandia), tolazamide (Tolinase), tolbutamide (Orinase). Hyperlipidemia- atorvastatin (Lipitor), fenofibrate (Tricor), gemfibrozil (Lopid), pravastatin (Pravachol). Wasting- cyproheptadine (Periactin), dronabinol (Marinol), megestrol acetate (Megace), testosterone replacement products (All types), thalidomide (Thalid). ALL OTHERS albuterol inhaler (Ventolin), albuterol/ipratropium (Combivent), alprazolam (Xanax), amitriptyline (Elavil), amoxapine (Asendin), amoxicillin (Amoxil, Polymox, Trimox), amoxicillin/pot. clavulante (Augmentin), ampicillin (Omnipen, Principen), beclomethasone (Beclovent, Vanceril), budesonide (Pulmicort), buproprion (Zyban, Wellbutrin), cefixime (Suprax), cefuroxime (Ceftin), cephalexin (Keflex, Biocef, Keftab), chlordiazepoxide (Librium), citalopram hydrobromide (Celexa), clomipramine (Anafranil), clorazepate (Tranxene), desipramine (Norpramin), diazepam (Valium), dicloxacillin (Dycil, Dynapen, Pathocill), doxepin (Sinequan), doxycycline (Doxy, Doxychel, Monodox, Vibramycin), estazolam (Prosom), flunisolide (Aerobid), fluoxetine (Prozac), flurazepam (Dalmane), fluticasone (Flovent), fluvoxamine (Luvox), gabapentin (Neurontin), imipramine (Tofranil), ipratropium (Atrovent), lamotrigine (Lamictal), levofloxacin (Levaquin), lithium (Eskalith, Lithobid), loperamide HCL (Imodium), lorazepam (Ativan), maprotiline (Ludiomil), metaproterenol (Alupent), mirtazapine (Remeron), nefazodone (Serzone), nicotene replacement products - all forms, nortriptyline (Aventyl, Pamelor), olanzapine (Zyprexa), oxazepam (Serax), paroxetine HCL (Paxil), penicillin (Pen Vee K, Veetids, Beepen-VK, V-Cillin K), pirbuterol (Maxair), prochloparazine (Compazine), protriptyline (Vivactil), pyridoxine (Vitamine B-6), salmeterol (Serevent), sertraline (Zoloft), terbutaline (Brethine, Brethaire), trazodone (Desyrel), triazolam (Halcion), triamcinolone (Azmacort), trimipramine (Surmontil), venlaxifine HCL (Effexor).

ADAP FORMULARIES Distric of Columbia ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), cidofovir (Vistide), clarithromycin (Biaxin), fluconazole (Diflucan), ganciclovir (Cytovene), isoniazid (INH), itraconazole (Sporonox), pyrazinamide, pyrimethamine (Daraprim), rifampim, sulfadiazine, TMP/SMX (Bactrim). Other OIs- amphotericin B (Fungizone), atovaquone (Mepron), ciprofloxacin (Cipro), clindamycin (Cleocin), clotrimazole (Lotrimin, Mycelex), dapsone, doxorubicin (Doxil), ethambutol (Myambutol), ketoconazole (Nizoral), ofloxacin (Floxin), pentamidine (NebuPent), rifabutin (Mycobutin), valacyclovir (Valtrex). Hepatitis C- interferon alpha. TREATMENTS FOR METABOLIC DISORDERS Diabetic- Metformin, glipizide (Glucotrol XL). Hyperlipidemia- atorvastatin (Lipitor). Wasting- dronabinol (Marinol), megestrol acetate (Megace), oxandrolone (Oxandrin). ALL OTHERS acetomenaphine with codeine (Tylenol III and Tylenol IV), amoxicillin/clavulanate (Augmentin), dephenoxylate and atropine (Lomotil), fentanyl patch (Duragesic), fluoxetine HCL (Prozac), hydrocortisone cream 1%, ibuprofen (800mg), morphine sulfate (MS Contin), sertraline HCL (Zoloft).

Florida ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx, Videx EC), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), clarithromycin (Biaxin), fluconazole (Diflucan), itraconazole (Sporonox), leucovorin (Folinic Acid), pyrimethamine (Daraprim), TMP/SMX (Bactrim, Septra). Other OIs- atovaquone (Mepron), dapsone (DDS), erythropoietin (Epogen, Procrit), ethambutol (Myambutol), filgrastim (Neupogen), miconazole (Monistat), rifabutin (Mycobutin), terconazole (Terazol). Hepatitis C- none. TREATMENTS FOR METABOLIC DISORDERS Diabetic- glipizide (Glucotrol), glyburide (Micronase, Glynase, Diabeta), metformin (Glucophage). Hyperlipidemia- atorvastatin (Lipitor), gemfibrozil (Lopid), pravastatin (Pravachol). Wasting- megestrol (Megace), nandrolone (Deca-Durabolin), oxandrolone (Oxandrin), testosterone cypionate. ALL OTHERS amitriptyline (Elavil), diphenoxylate (Lomotil), gabapentin (Neurontin), hepatitis A Vaccine (Havrix), hepatitis B Vaccine (Engerix B), lamotrigine (Lamictal), nortriptyline (Pamelor), pneumococcal vaccine (Pneumovax), procholorperazine (Compazine).

Georgia ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx, Videx EC ), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), clarithromycin (Biaxin), fluconazole (Diflucan), ganciclovir (Cytovene), isoniazid (INH), itraconazole (Sporonox), leucovorin (Wellcovorin), pyrazinamide, pyrimethamine (Daraprim), rifampim (Rifadin), sulfadiazine, TMP/SMX (Bactrim). Other OIs- atovaquone (Mepron), clindamycin (Cleocin), clotrimazole (Mycelex troches), dapsone (Avlosulfon), erythropoietin (Epogen, Procrit), ethambutol (Myambutol), flucytosine (Ancobon), gabapentin (Neurontin), ketoconazole (Nizoral), loperamide (Imodium), nystatin (Mycostatin / Nilstat), prednisone (Deltasone), primaquine, prochlorperazine (Compazine), rifabutin (Mycobutin), trimethoprim (TimpexProlorim). Hepatitis C- none.

ADAP FORMULARIES Guam ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), cidofovir (Vistide), clarithromycin (Biaxin), famciclovir (Famvir), fluconazole (Diflucan), foscarnet (Foscavir), ganciclovir (Cytovene), itraconazole (Sporonox), leucovorin, pyrimethamine (Daraprim), TMP/SMX (Bactrim). Other OIs- atovaquone (Mepron), cephalexin (Keflex), ciprofloxicin (Cipro), clinamycin, clotrimazole (Mycelex), dapsone, erythropoietin (Procrit), filgrastim (Neupogen, G-CSF), ketoconazole (Nizoral), pentamidine (Nebupent), rifabutin (Mycobutin). Hepatitis C- none. TREATMENTS FOR METABOLIC DISORDERS Wasting- megestrol acetate (Megace). ALL OTHERS aliretinoin (Panretin), fluoxetine (Prozac), hydrocortisone cream.

Hawaii ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx, Videx EC), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), cidofovir (Vistide), clarithromycin (Biaxin), famciclovir (Famvir), fluconazole (Diflucan), foscarnet (Foscavir), ganciclovir (Cytovene), isoniazid (INH), itraconazole (Sporonox), leucovorin, pyrazinamide, pyrimethamine (Daraprim), rifampim (Rifadin), sulfadiazine, TMP/SMX (Septra). Other OIs- amphotericin B, atovaquone (Mepron), ciprofloxacin (Cipro), clindamycin, clofazimine (Lamprene), clotrimazole (Mycelex), dapsone, daunorubicin (DaunoXome), epoetin alfa (Procrit), ethambutol (Myambutol), filgrastim (Neupogen), ketoconazole (Nizoral), metronidazole (Flagyl), nystatin, paclitaxel (Taxol), paromomycin (Humatin), pentamidine (NebuPent), prochlorperazine (Compazine), rifabutin (Mycobutin), terbinafine (Lamisil), valacyclovir (Valtrex), valgancyclovir (Valcyte). Hepatitis C- none. TREATMENTS FOR METABOLIC DISORDERS Diabetic- glyburide, metformin (Glucophage), tetracycline. Hyperlipidemia- atorvastatin (Lipitor), fenofibrate (Tricor), gemfibrozil (Lopid), niaspan, pravastatin (Pravachol). Wasting- megestrol acetate (Megace), nandrolone decanoate (Deca-Durabolin), oxandrolone (Oxandrin), testosterone cypionate (DepoTest), testosterone (AndroGel). ALL OTHERS alitretinoin (Panretin Gel), bupropion (Wellbutrin), cephalexin (Keflex), citalopram (Celexa), diclosacillin, diphenoxylate HCI (Lomotil), doxycycline, erythromycin (ERY-TAB), fluoxetine (Prozac), gabapentin (Neurontin), hydrocortisone cream, imiquimod (Aldara cream), loperamide (Imodium), mirtazapine (Remeron), mupirocin (Bactroban), pancrelipase (Ultrase), paroxetine (Paxil), phisohex, sertraline (zoloft), venlafaxine hydrochloride (Effexor).

Idaho ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx, Videx EC), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- TMP/SMX (Bactrim). Other OIs- dapsone. Hepatitis C- none.

ADAP FORMULARIES Illinois ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx, Videx EC), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), cidofovir (Vistide), clarithromycin (Biaxin), famciclovir (Famvir), fluconazole (Diflucan), foscarnet (Foscavir), ganciclovir (Cytovene), isoniazid (INH), itraconazole (Sporonox), leucovorin (Folinic Acid), pyrazinamide, pyrimethamine (Daraprim), rifampim (Rifadin, Rimactane, Rifater), sulfadiazine, TMP/SMX (Bactrim, C0-Trimoxazole, Septra, Sulfatrim). Other OIs- amphotericin B (Fungizone), atovaquone (Mepron), ciprofloxacin (Cipro), clindamycin HCL (Cleocin HCL), clindamycin phosphate (Cleocin Phosphate), clindamycin palmitate (Cleocin pediatirc), clotrimazole (Lotrimin, Mycelex), dapsone (DDS), ethambutol (Myambutol), ketoconazole (Nizoral), miconazole (Monistat), nystatin (Mycostatin), ofloxacin (Floxin), paromomycin sulfate (Humatin), pentamidine (Nebupent, Pentam), primaquine phosphate, rifabutin (Mycobutin), streptomycin sulfate, sulfamethoxazole (Gantanol, Urobak), terconazole (Terazol 3, 7), trimethoprim (TMP, Proloprim, Trimpex). Hepatitis C- interferon alpha-2b (Intron A). TREATMENTS FOR METABOLIC DISORDERS Wasting- dronabinol (Marinol), megestrol acetate (Megace). ALL OTHERS amoxicillin (Amoxil, Trimox, Wymox), cefixime (Suprax), cephalexin monohydrate (Keflex), chlorhexidine gluconate (Peridex, PerioGard), danazol (Danocrine), dicloxacillin sodium (Dycill, Dynapen, Pathocil), doxycycline (Doryx, Vibramycin, Vibra-Tabs), erythromycin ethylsuccinate (E.E.S.), penicillin VK, tetracycline (Achromycin V, Sumycin, Tetracyn).

Indiana ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx, Videx EC), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), clarithromycin (Biaxin), famciclovir (Famvir), fluconazole (Diflucan), ganciclovir (Cytovene), itraconazole (Sporonox), leucovorin, TMP/SMX (Bactrim, Septra). Other OIs- amphotericin B (Ancobon), atovaquone (Mepron), clotrimazole (Gyne-Lotrimum, Mycelex), dapsone, flucytosine, ketoconazole (Nizoral), metronidazole (Flagyl), nystatin (Mycostatin), pentamidine (NebuPent, Pentam), rifabutin (Mycobutin). Hepatitis C- none. TREATMENTS FOR METABOLIC DISORDERS Wasting- Testosterone. ALL OTHERS acetaminophen + codeine (Tylenol #3, Tylenol + codeine), amantadine (Symmetrel), amitriptyline (Elavil), bromocriptine, bupropion (Wellbutrin), buspirone (BuSpar), chlorhexidine gluconate (Peridex), clonidine hydrochloride (ApoClonidine, Catapress, Nu-Clonidine), carbamazepine (Tegretol), desipramine (Norpramine, Pertofrane), diphenhydramine (Benadryl), diphenoxylate atropine (Lomotil), disulfiram (Antabuse), fluoxetine (Prozac), hydroxyzine (Vistaril, Atarax), klonopin (Clonazepam), levo-alpha-acetyl-methadol (LAAM),lithium carbonate, methadone (Dolophine, Methadone), morphine sulfate (Oramorph analgesic patches), naloxone (Narcan), naltrexone (ReVia), nefazodone (Serzone), paroxetine (Paxil), phenobarbital (Solfoton), phenytoin (Dilantin), povidone-iodine (Betadine), prochlorperazine (Compazine), propranolol (Inderal), sertraline (Zoloft), sodium valproate (Depakote), tramadol hydrochloride (Ultrarn), trazodone (Desyreo), tricyclic antidepressants (Sinequan, Tofranil), venlafaxine (Effexor).

ADAP FORMULARIES Iowa ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), clarithromycin (Biaxin), fluconazole (Diflucan), itraconazole (Sporonox), TMP/SMX (Bactrim, Septra). Other OIs- atovaquone (Mepron), clotrimazole (Mycelex), dapsone, ethambutol (Myambutol), ketoconazole (Nizoral), nystatin (Mycostatin), pentamidine (Pentam), rifabutin (Mycobutin). Hepatitis C- none.

Kansas ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx, Videx EC), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax),clarithromycin (Biaxin), famciclovir (Famvir), fluconazole (Diflucan), ganciclovir (Cytovene), itraconazole (Sporonox), TMP/SMX (Bactrim, Septra). Other OIs- atovaquone (Mepron), clindamycin (Cleocin), clotrimazole (Mycelex), dapsone, ethambutol (Myambutol), ketoconazole (Nizoral), Metronidazole (Flagyl), nystatin (Mycostatin), paromomycin (Humatin), pentamidine (Nebupent), rifabutin (Mycobutin). Hepatitis C- none. TREATMENTS FOR METABOLIC DISORDERS Wasting- dronabinol (Marinol), megestrol acetate (Megace), oxandrolone (Oxandrin). ALL OTHERS amitriptyline, cephalexin (Keflex), cephalexin hydrochloride (Keftab), clonazepam (Klonopin), trazodone (Desyrel).

Kentucky ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx, Videx EC), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), clarithromycin (Biaxin), fluconazole (Diflucan), leucovorin (Wellcovorin), TMP/SMX (Bactrim, Septra). Other OIs- ciprofloxacin (Cipro), clindamycin (Cleocin), clotrimazole (Mycelex), dapsone, ethambutol (Myambutol), ketoconazole (Nizoral), nystatin (Mycostatin), primaquine, rifabutin (Mycobutin). Hepatitis C- none. TREATMENTS FOR METABOLIC DISORDERS Wasting- megestrol acetate (Megace). ALL OTHERS prenatal vitamins.

Louisiana ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune).

ADAP FORMULARIES Maine ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx, Videx EC), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), cidofovir (Vistide), clarithromycin (Biaxin), famciclovir (Famvir), fluconazole (Diflucan), foscarnet (Foscavir), ganciclovir (Cytovene), isoniazid (INH), itraconazole (Sporonox), leucovorin, pyrazinamide, pyrimethamine (Daraprim, Fansidar), rifampim, sulfadiazine, TMP/SMX (Bactrim). Other OIs- ciprofloxacin (Cipro), dapsone, ethambutol (Myambutol), pentamidine (Nebupent). Hepatitis C- none.

Maryland ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), cidofovir (Vistide), clarithromycin (Biaxin), famciclovir (Famvir), fluconazole (Diflucan), foscarnet (Foscavir), ganciclovir (Cytovene), isoniazid (Nydrazid, Rifamate), itraconazole (Sporonox), leucovorin, pyrazinamide, pyrimethamine (Daraprim, Fansidar), rifampim (Rifadin, Rimactane), sulfadiazine, TMP/SMX (Bactrim). Other OIs- amphotericin B (Fungisone), atovaquone (Mepron), ciprofloxacin (Cipro,Ciloxan), clindamycin (Cleocin), clotrimazole (Lotrimin, Mycelex), dapsone, daunorubicin citrate liposomal (DaunoXome), ethambutol (Myambutol), epoetin alpha (Epogen, Procrit), filgrastim (Neupogen), fomivirsen (Vitravene), ketoconazole (Nizoral), miconazole (Monistat), nystatin (Mycostatin), paromomycin (Humatin), pentamidine (Pentam, Nebupent), rifabutin (Mycobutin), valacyclovir (Valtrex). Hepatitis C- interferon alpha-2A (Roferon-A, Intron-A). TREATMENTS FOR METABOLIC DISORDERS Hyperlipidemia- atorvastatin (Lipitor), pravastatin (Pravachol). Wasting- megestrol acetate (Megace), nandrolone, oxandrolone (Oxandrin), testosterone (injection and patches), thalidomide (Thalomid). ALL OTHERS amitriptyline (Elavil), buproprion (Wellbutrin, Zyban), citalopran HBr (Celexa), clotrimazole/betamethasone (Lotrisone Cream), diphenoxylate-atropine (Lomotil), divalproex (Depakote, Depakene), fluoxetine (Prozac), fluphenazine (Prolixin), gabapentin (Neurontin), haldoperidol (Haldol), hydroxizine (Atarax), imiquimod (Aldara), loperamide (Imodium), nortriptyline (Aventlyl, Pamelor), octreotide (Sandostatin), olanzapine (Zyprexa), oxymetholone (Anadrol-50), paroxetine (Paxil), prochlorperazine (Compazine), risperidone (Risperdal), sertraline (Zoloft), trazadone (Desyrel/Desyrel Dividose).

Massachusetts ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx, Videx EC), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), cidofovir (Vistide), clarithromycin (Biaxin), famciclovir (Famvir), fluconazole (Diflucan), foscarnet (Foscavir), ganciclovir (Cytovene), isoniazid (INH), itraconazole (Sporonox), leucovorin, pyrazinamide, pyrimethamine (Daraprim, Fansidar), rifampim, sulfadiazine, TMP/SMX (Bactrim). Hepatitis C- all FDA approved drugs. ALL OTHERS Open Formulary - All FDA approved drugs are covered except the following: Specific open formulary exclusions: antirheumatic injectables (e.g. Enbrel), botulinum toxin (e.g. botox, mylobloc) compounded medications for infusion, active medication containing more than one ingredient, gonadotropin, finasteride (Propecia), hyaluronic acid derivatives (e.g. Hyalgan, Synvisc), immune globulin intravenous IGIV (e.g. sandoglobulin, Venoglobulin), injectable muscle relaxants (e.g. Lioresal), mifepristone, minoxidil (Rogaine), monoclonal antibodies (e.g. Remicade, Synagis), propoxyphene, recombinant human growth hormone HGH (e.g. Geref, Humatrop), Viagra. Class Exculsions:fertility drugs, fluorides, herbal medicaitons, immunizing biologicals, iron, less than effective drugs, nutritional supplements, over the counter mediations exceptions:(Acetaminophen, Imodium and Metamucil), sex-reassignment drugs, smoking cessaton drugs, vitamins and minerals.

ADAP FORMULARIES Michigan ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), cidofovir (Vistide), clarithromycin (Biaxin), famciclovir (Famvir), fluconazole (Diflucan), foscarnet (Foscavir), ganciclovir (Cytovene), itraconazole (Sporonox), leucovorin, pyrimethamine, sulfadiazine, TMP/SMX (Bactrim, Cotrim, Septra). Other OIs- amphotericin B (Fungizone), atovaquone (Mepron), ciprofloxacin (Cipro), clindamycin, clotrimazole (Mycelex), dapsone, ethambutol (Myambutol), formivirsen (Vitravene), ketoconazole (Nizoral), ofloxacin (Ocuflox), pentamidine (Nebupent, Pentam), primaquine, rifabutin (Mycobutin), valacyclovir (Valtrex). Hepatitis C- none. TREATMENTS FOR METABOLIC DISORDERS Cardiac- enalapril (Vasotec), furosemide (Lasix), hydrochlorothyazide, nifedipine (Procardia), quinapril (Accupril). Diabetic- insulin/syringes, metformin (Glucophage). Hyperlipidemia- atorvastatin (Lipitor), fenofibrate (Tricor), gemfibrozil (Lopid). Wasting- megestrol acetate (Megace), testosterone (Testoderm, Delatestryl, Androderm). ALL OTHERS albuterol (Airet, Proventil, Ventolin, Volmax), alprazolam (Xanax), amitriptyline (Elavil), bupropion (Wellbutrin, Zyban), buspirone (Buspar), cetrizine (Zyrtec), diphenoxylate (Lomotil), doxycycline (Monodox), erythromycin, famotidine (Pepcid), fexofenadine (Allegra), fluoxetine (Prozac), gabapentin (Neurontin), hepatitis A Vaccine, hepatitis B Vaccine, influenza Vaccine, lansoprazole (Prevacid), laratadine-pseudoephedrine (Claritin), levofloxacin (Levaquin), loperamide (Imodium), lorazepam (Ativan), nicotine (Nicotrol, Habitrol, NTC), omeprazole (Prilosec), paroxetine (Paxil), pneumococcal Vaccine (Pneumovax), prochlorperazine (Compazine), rimantadine (Flumadine), Respirgard II (Nebulizer), setraline (Zoloft), trimethobenzamide (Tigan), zolpidem (Ambien).

Minnesota ANTIRETROVIRALS NRTIs- abacavir/lamivudine/zidovudine (Trizivir), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Invirase). NnRTIs- nevirapine (Viramune). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), cidofovir (Vistide), clarithromycin (Biaxin), fluconazole (Diflucan), ganciclovir (Cytovene), itraconazole (Sporonox), leucovorin (Wellcovorin), pyrazinamide, pyrimethamine (Daraprim), rifampim/isonazid (Rifadin, Rifamate), sulfadiazine, TMP/SMX (Bactrim, Septra). Other OIs- albendazole (Albenza), amphotericin B (Fungizone), atovaquone (Mepron), ciprofloxacin (Cipro), clindanycin (Cleocin), clotrimazole (Lotrimin, Mycelex), dapsone, econazole (Spectazole), ethambutol (Myambutol), ketoconazole (Nizoral), metronidazole (Flagyl ,Metrogel), miconazole (Micatin, Moniatat, Zeasorb-AF), nystatin (Mycostatin), ofloxacin (Ocuflox), paromonycin (Humatin), pentamidine (Nebupent, Pentam), primaquine, rifabutin (Mycobutin), silver sulfadiazine (Thermazene SSD), terconazole (Terazol 7), Valacyclovir (Valtrex), Valgancyclovir (Valcyte). Hepatitis C- none. TREATMENTS FOR METABOLIC DISORDERS Hyperlipidemia- atrovostatin (Lipitor), cholestyramine (Questran), fenofibrate (Tricor), fulvastatin (Lescol), gemfibrozil (Lopid), niacin (Niaspan), pravastatin (Pravachol), simvastatin (Zocor). ALL OTHERS amoxicillin, amoxicillin/culvulanate (Augmentin), bacitracin, bacitracin/polymyxinB, bacitracin Zinc, carbamazepine (Tegretol), cefadroxil (Duricef), cefazolin (Ancef), cephalexin (Keflex), chlor-hexidine (Peridex), colfazamine (Lamprene), desipramine (Norpramin, Petrofane), dicloxacillin, divalproex (Depakote), doxepin (Sinequan), doxycycline (Vibramycin), erythromycin (EES), erythromycin/ethanol, fluoxetine (Prozac), fluvoxamine (Luvox), gabapentin (Neurontin), gentamicin, imipramine (Tofranil), lamotrigine (Lamictal), levofloxacin (Levaquin), magnesium sulfate, maprotiline (Ludiomil), minocycline (Minocin), mirtazapine (Remeron), nefazodone (Serzone), neomycin, nitrofurantoin (Macrodantin), nortriptyline (Aventyl, Pamelor), paroxetine (Paxil), penicillin V Potassium (Vestids), phenelzine (Nardil), phenytoin (Dilantin), primidone (Mysoline), probenecid, protriptyline (Vivactil), sertraline (Zoloft), tetracycline, tranylcypromine (Pamate), trazodone (Desyrel, Trialodine), trimipramine (Surmontil), tobramycin, vancomycin, valporic acid (Depkene), venlafxine (Effexor).

ADAP FORMULARIES Mississippi ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx, Videx EC), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), clarithromycin (Biaxin), fluconazole (Diflucan), ganciclovir (Cytovene), itraconazole (Sporonox), pyrimethamine (Daraprim), sulfadiazine, TMP/SMX (Bactrim). Other OIs- clotrimazole (Mycelex), dapsone, ethambutol (Myambutol), pentamidine. Hepatitis C- none. TREATMENTS FOR METABOLIC DISORDERS Hyperlipidemia- atorvastatin (Lipitor), niacin. Wasting- oxandrolone (Oxandrin). ALL OTHERS amitriptyline (Elavil), gabapentin (Neurontin), sertraline (Zoloft).

Missouri ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir, azithromycin, clarithromycin, famciclovir, fluconazole, ganciclovir, isoniazid, itraconazole, leucovorin, pyrimethamine, rifampim, sulfadiazine, TMP/SMX. Other OIs- atovaquone, ciprofloxacin, clindamycin, clofazimine, clotrimazole, dapsone, econazole, ethambutol, griseofulvin, ketoconazole, miconazole, nystatin, ofloxacin, paromomycin, pentamidine, primaquine, rifabutin, terbinafine, terconazole, valacyclovir, valganciclovir. Hepatitis C- none. TREATMENTS FOR METABOLIC DISORDERS Cardiac- acebutolol, amiloride, amlodipine, atenolol, benazepril, captopril, cardizem, chlorothiazide, chlorthalidone, clonidine, diltiazem, doxazosin mesylate, enalapril, fosinopril, furosemide, hydrochlorothiazide, irbesartan, labetalol, lisinopril, methyldopa, metoprolol, nifedipine, nisoldipine, prazosin, propranolol, quinapril, ramipril, spironolactone, terazosin, triamterene, verapamil. Diabetic- acarbose, chlorpropamide, gilmepiride, glipizide, glyburide, insulin, metformin, miglitol, pioglitazone, rosiglitazone, tolazamide, tolbutamide. Hyperlipidemia- atorvastatin, cholestyramine, clofibrate, colestipol, fenofibrate, fluvastatin, gemfibrozil, lovastatin, niacin, pravastatin, simvastatin. Wasting- cyproheptadine, dronabinol, megestrol acetate, nandrolone, oxandrolone, oxymetholone, testosterone. ALL OTHERS acetaminophen /codine, albuterol inhaler, alprazolam, amitriptyline, amoxicillin trihydrate, amoxicillin & clavulanate potassium, ampicillin, baclofen, beclomethasone, benzoropine, betamethasone, bupropion, buspirone, carbamazepine, carbidopa, carisoprodol, cefaclor, cefadroxil, cefdinir, cefprozil, cefixime, ceftibutin, cefuroxime, clecoxib, cephalexin, cetirizine, chlordiazepoxide, chlorpromazine, chlorzoxazone, cimetidine, citalopram, clemastine, clobetasol, clomipramine, clonazepam, codeine, cromolyn, cyclobenzaprine, desipramine, desoximetasone, dexamethasone, diazepam, diclofenac, dicloxacillin, dicyclomine, diflunisal, diphenhydramine, diphenoxylate, divalproex sodium, dolasetron, doxepin, doxycycline, erythromycin, etodolac, famotidine, fenoprofen, fentanyl, fexofenadine, flucytosine, flunisolide, fluocinolone, fluocinonide, fluoxetine, flurazepam, fluticasone, fluvoxamine, furazolidone (Furoxone), gabapentin, granisetron, halcionoide, haloperido, hepatitis A vaccine, hepatitis B vaccine, hydrocodone, hydrocortisone, hydromorphone, hydroxyzine, ibuprofen (prescription strength), imipramine, indomethacin, ipratropium, ketoprofen, ketorolac, lamotrigine, lansoprazole, levofloxacin, lithium, loperamide, loracarbef, loratadine, lorazepam, meclizine, meperidine, mepivacaine, metaxalone, methadone, methocarbamol, metoclopramide, metronidazole, minocycline, mirtazapine, mometasone, montelukast, morphine immediate release, mupirocin, naproxen, nefazodone, nitrofurantoin, nizatidine, nortriptyline, olanzapine, omeprazole, ondansetron, orphenadrine, oxaprozin, oxazepam, oxycodone combinations, pancrelipase, paroxetine, penicillin, phenytoin, pirbuterol, piroxicam, prednisone, primidone, prochlorperazine, promethazine, propoxyphene combinations, ranitidine, risperidone, rofecoxib, salmeterol, sertraline, sparfloxacin, sucralfate, sulindac, temazepam, terbutaline, tetracycline, theophylline, thiothixene, timolol, tolmetin, tramadol, trazodone, triamcinolone, trifluoperazine, trimethobenzamide, trovafloxacin, valporic acid, vancomycin, venlafaxine, zolpidem.

ADAP FORMULARIES Montana ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx, Videx EC), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), clarithromycin (Biaxin), fluconazole (Diflucan), foscarnet (Foscavir), ganciclovir (Cytovene), isoniazid (INH), itraconazole (Sporonox), leucovorin (floinic acid), pyrazinamide (Rifater), pyrimethamine (Daraprim, Fansidar), rifampim (If not covered by County Health), sulfadiazine, TMP/SMX (Bactrim). Other OIs- amphotericin B (standard formulation only), atovaquone (Mepron), dapsone, ethambutol hydrochloride (Myambutol), rifabutin (Mycobutin), clotrimazole oral (Mycolex Troches), nystatin (Mycostatin), pentamidine (NebuPent/Pentam), Valacyclovir (Valtrex ). Hepatitis C- none.

Nebraska ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx, Videx EC), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), clarithromycin (Biaxin), famciclovir (Famvir), fluconazole (Diflucan), isoniazid (Laniazid), itraconazole (Sporonox), pyrazinamide, rifampim (Rifadin), TMP/SMX (Bactrim, Septra). Other OIs- atovaquone (Mepron), ciprofloxacin (Cipro), clindamycin (Cleocin), clofazimine (Lamprene), clotrimazole (Mycelex), dapsone, ethambutol (Myambutol), ketoconazole (Nizoral), nystatin (Mycostatin), metronidazole (Flagyl), pentamidine (Pentam), rifabutin (Mycobutin), valacyclovir (Valtrex). Hepatitis C- none. TREATMENTS FOR METABOLIC DISORDERS Wasting- megestroll acetate (Megace). ALL OTHERS alprazolam (Xanax), amitriptyline (Elavil), buspirone (BuSpar), bupropion (Weflbutrin), carbamazepine (Tegretol), chlordiazepoxide (Librium), chlorpromazine (Thorazine), citalopram (Celexa), clomipramine (Anafrabil), clonazepam (Klonopin), clorazepate (Tranxene), clozapine (Clozaril), desipramine (Norpramin), diazepam (Valium), doxepin (Sinequan), droperidol (Inapsine), estazolam (Prosom), fluoxetine (Prozac), fluphenazine (Prolixin), flurazepam (Dalmane), fluvoxamine (Luvox), halazepam (Paxipam), haloperidol (Haldol), hydroxyzine (Atarax, Vistaril), imipramine (Tofranil), lithium (Lithobid), lorazepam (Ativan), loxapine (Loxitane), mesoridazine (Serentil), mirtazipine (Remeron), molindone (Moban), nefazodone (Serzone), nortriptyline (Pamelor), olanzapine (Zyprexa), oxazepam (Serax), paroxetine (Paxil), perphanazine (Trilafon), pimozide (Orap), prazepam (Centrax), prochlorperazine (Compazine), quetiapine (Seroquel), risperidone (Risperdal), sertraline (Zoloft), temazepam (Restoril), thioridazine (Mellaril), thiothixene (Navane), trazodone (Desyrel), triazolam (Halcion), trifluoperazine (Stelazine), trimipramine (Surmontil), venlaxafine (Effexor), zolpidem (Ambien).

Nevada ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir, azithromycin (Zithromax), clarithromycin (Biaxin), fluconazole (Diflucan), ganciclovir (Cytovene), itraconazole (Sporonox), leucovorin, pyrimethamine, sulfadiazine, TMP/SMX (Septra). Other OIs- ciprofloxacin (Cipro), clindamycin (Cleocin), clotrimazole (Mycelex), dapsone, erythropoietin, ethambutol (Myambutol), GCSF (Neupogen), nystatin (Nilstat), paromomycin (Humatin). Hepatitis C- none. TREATMENTS FOR METABOLIC DISORDERS Hyperlipidemia- pravastatin (Pravachol). Wasting- dronabinol (Marinol), megestrol acetate (Megace), oxandrolone (Oxandrin), testosterone. ALL OTHERS amitriptyline (Elavil), diphenoxylate/atropine (Lomotil), gabapentin (Neurontin), loperamide (Imodium), ondansetron (Zofran), pancreatic enzymes (Ultrase), prochlorperazine (Compazine), trazadone (Desyrel).

ADAP FORMULARIES New Hampshire ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), clarithromycin (Biaxin), famciclovir (Famvir), fluconazole (Diflucan), ganciclovir (Cytovene), isoniazid (Rifater), itraconazole (Sporonox), leucovorin (Wellcovorin), pyrazinamide, pyrimethamine (Daraprim), rifampim (Rimactane, Rifadin), TMP/SMX (Bactrim, Septra). Other OIs- atovaquone (Mepron), ciprofloxacin (Cipro), clindamycin (Cleocin), clotrimazole (Lotrimin, Mycelex), dapsone, ethambutol (Myambutol), ketoconazole (Nizoral), metronidazole (Flagyl), nystatin (Mycostatin), pentamidine (Pentam), primaquine, rifabutin (Mycobutin), trimethoprim (Proloprim, Trimpex), valacyclovir (Valtrex), valganciclovir (Valcyte). Hepatitis C- none. TREATMENTS FOR METABOLIC DISORDERS Hyperlipidemia- atorvastatin (Lipitor), fenofibrate (Tricor), gemfibrozil (Lopid), pravastatin (Pravachol), simvastatin (Zocor). Wasting- dronabinol (Marinol), megestrol acetate (Megace), oxandrolone (Oxandrin), testosterone (Testoderm). ALL OTHERS bupropion (Wellbutrin, Zyban), cephalexin (Keflex), cefuroxime (Ceftin), chloroquine (Aralen), citalopram (Celexa), clonazepam (Klonopin), dicloxacillin, diphenoxylate/atropine (Lomotil AD), divalproex (Depakote), famotidine (Pepcid), fluoxetine (Prozac), gabapentin (Neurontin), granisetron (Kytril), lansoprazole (Prevacid), levofloxacin (Levaquin), lorazepam (Ativan), mirtazapine (Remeron), nefazodone (Serazone), olanzapine (Zyprexa), omeprazole (Prilosec), ondansetron (Zofran), oxazepam (Serax), panrelipaxe (Ultrase), paroxetine (Paxil), penicillin (V-Cillin K), ranitidine (Zantac), risperidone (Risperdal), sertraline (Zoloft), terbinafine (Lamisil), venlafaxine (Effexor).

New Jersey ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx, Videx EC), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), cidofovir (Vistide), clarithromycin (Biaxin), famciclovir (Famvir), fluconazole (Diflucan), foscarnet (Foscavir), ganciclovir (Cytovene), isoniazid (INH), itraconazole (Sporonox), leucovorin, pyrazinamide, pyrimethamine (Daraprim, Fansidar), rifampim, sulfadiazine, TMP/SMX (Bactrim). Hepatitis C- all FDA approved drugs. ALL OTHERS Open Formulary. all FDA approved drugs are covered. Specific exclusions: cosmetics, fertility drugs, less than effective drugs, over the counter mediations. impotence treatments limited to four times a year.

ADAP FORMULARIES New Mexico ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), clarithromycin (Biaxin), famciclovir (Famvir), fluconazole (Diflucan), foscarnet (Foscavir), ganciclovir (Cytovene), itraconazole (Sporonox), leucovorin, pyrimethamine (Daraprim), sulfadiazine, TMP/SMX (Bactrim, Septra). Other OIs- amikacin (Amikin), amphotericin B, atovaquone (Mepron), ciprofloxacin (Cipro), clindamycin (Cleocin), clofazimine (Lamprene), clotrimazole (Mycelex), dapsone, erythropoietin (Epogen), ethambutol (Myambutol), filgrastim (G-CSF, Neupogen), ketoconazole (Nizoral), metronidazole (Flagyl), nystatin (Mycostatin), pentamidine (Nebupent, Pentam), primaquine, rifabutin (Mycobutin), trimethoprim (Proloprim), valacyclovir (Valtrex), valganciclovir (Valcyte). Hepatitis C- none. TREATMENTS FOR METABOLIC DISORDERS Diabetic- metformin (Glucophage). Hyperlipidemia- atorvastatin (Lipitor), gemfibrozil (Lopid), pravastatin (Pravachol). WastingMegestrol (Megace). ALL OTHERS Centrum Silver, Nizoral Cream, Prenatal-S, sertraline (Zoloft), Tegrin Shampoo. contraceptives (condoms with/without nonoxynol 9, Spermicidal Foam, VCF Spermicidal Film, Depo-Provera, Norplant, Ovulation thermometer, Fertility Awareness book, charts, videotape“All Methods” counseling pamphlet, Oral Contraceptives, Loestrin Fe, Micronor, Nordette, Ortho-Cyclen, Ortho Novum, Triphasil)

ADAP FORMULARIES New York ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx, Videx EC), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir, azithromycin, cidofovir, clarithromycin, famciclovir, fluconazole, foscarnet, ganciclovir, isoniazid, itraconazole, leucovorin, pyrazinamide, pyrimethamine, rifampim, rifampim in combination, sulfadiazine, TMP/SMX. Other OIs- albendazole, amikacin, amphotericin B, atovaquone, bleomycin, capreomycin, ciprofloxacin, clindamycin, clotrimazole, cyclophosphamide, cycloserine, cytarabine, dapsone, dexamethasone, doxorubicin, econazole nitrate, epoetin alfa, ethionamide, ethambutol, etoposide, filgrastim, flucytosine, formivirsen, griseofulvin, immune globulin Rho (Win Rho SDF), IVIG, kanamycin, ketoconazole, liposomal doxorubicin, liposomal daunorubicin, lomustine, miconazole, methotrexate, nystatin, ofloxacin, oprelvekin (Neumega), paclitaxel, panretin gel, para-amino salicyclic acid, paromomycin, penciclovir, pentamidine, prednisone, primaquine, procarbazine, rifabutin, rifapentine, sargramostim, streptomycin, sulfadoxine/pyrimethamine, sulfamethoxazole, terbinafine, terconazole, trimethoprim, triple sulfa, valacyclovir, valgancyclovir, vinblastine, vincristine. Hepatitis C- alpha interferon, ribavirin. TREATMENTS FOR METABOLIC DISORDERS Cardiac- acebutolol, amiloride, amlodipine, atenolol, benazepril, bendroflumethiazide, betaxolol, bisoprolol,bumetanide, candesartan, captopril, carteolol, carvedilol, chlorothiazide, chlorthalidone, clonidine, cyclandelate, digoxin, diltiazem, doxazosin, enalapril, felodipine, fosinopril, furosemide,guanabenz, guanadrel, guanfacine, hydralazine, hydrochlorothiazide, hydroflumethiazide, indapamide, irbesartan, isosorbide, isoxsuprine, isradipine, labetalol, lisinopril, losartan, methyclothiazide, methyldopa, metolazone, metoprolol, minoxidil, moexipril, moricizine, nadolol, nicardipine, nifedipine, nisoldipine, nitroglycerin, papaverine, penbutolol, pindolol, polythiazide, prazosin, procainamide, propranolol, quinapril, ramipril, sotalol, spironolactone, telmisartan, terazosin, tocainide, torsemide, trandolapril, triamterene, trichlormethiazide, valsartan, verapamil. Diabetic- acarbose, acetohexamide, chlorpropamide, glimepiride, glipizide, glyburide, insulin, metformin, miglitol, pioglitazone, repaglinide, rosiglitazone, tolazamide, tolbutamide, troglitazone. Hyperlipidemiaatorvastatin, cerivastatin, cholestyramine, clofibrate, colestipol, fenofibrate, fluvastatin, gemfibrozil, lovastatin, niacin, pravastatin, simvastatin. Wasting- cyproheptadine, dronabinol, megestrol acetate, nandrolone, oxandrolone, testosterone, thalidomide. ALL OTHERS acetylcysteine, acrivastine/pseudoephedrine, albuterol, alclometasone, alpha N3, alprazolam, amcinonide, amitriptyline, amoxicillin, amoxicillin/clavulanate, ansaid, ampicillin, apraclonidine, atropine, azatadine, azatadine/pseudoephedrine, aztreonam, bacitracin, beclomethasone, benztropine mesylate, betamethasone dipropionate, betamethasone valerate, betaxolol, bitolterol, brimonidine, brinzolamide, brompheniramine w/wo combinations, budesonide, bupropion, buspirone, butabarbital, butalbital combination w/wo/ codeine, carbamazepine, carbinoxamine, carbinoxamine/pseudoephedrine, carteolol, cefaclor, cefadroxil, cefazolin, cefixime, cefoxitin, cefpodoxime, cefprozil, ceftazidime, ceftriaxone, cefuroxime, cephalexin, cephradine, cetirizine, chloral hydrate, chloramphenicol, chlordiazepoxide w/wo clidinium, chlorhexidine, chlorpheniramine w/wo/ combinations, chlorpromazine, cimetidine, citalopram, clemastine, clobetasol, clocortolone, clomipramine, clonazepam, clorazepate, cloxacillin, clozapine, codeine w/wo/ ASA, APAP, cromolyn sodium, cyclopentolate, demearium, desipramine, desonide, desoximetasone, dexbrompheniramine / pseudo, dexchlorpheniramine, dextroamphetamine sulfate, diazepam, diclofenac, dicloxacillin, diflorasone, diflunisal, diphenhydramine, diphenoxylate w/atropine sulfate, dipivefrin, divalproex sodium, dolasetron, dorzolamide, dorzolamide w/ timolol, doxepin, doxycycline, dyphylline, ecothiopate, epinephrine, epinephryl borate, erythromycin, erythromycin ethylsuccinate, erythromycin ethylsuccinate and sulfisoxazole acetyl, estrogen, estrogens w/progestins, famotidine, fenoprofen, fentanyl (patch only), fexofenadine hcl/pseudo,fexofenadine, flavoxate, flunisolide, fluoride, fluocinonide, fluorometh/sulfacetamide, fluorometholone, fluoxetine, fluphenazine,flurandrenolide, flurazepam, flurbiprofen, fluticasone, fluvoxamine, fosfomycin tromethamine, furazolidone, gabapentin, gentamicin, granisetron, halazepam, halcinonide, halobetasol, haloperidol, hepatitis A & B vaccines, homatropine, hydrocodone w/ ASA, APAP, hydrocortisone w/wo/ combinations, hydromorphone, hydoxyzine HCI, hydoxyzine pamoate, ibuprofen, imipenem/cilastatin, imipramine, imiquimod, indomethacin, ipratropium, ipratropium and albuterol, ketoprofen, ketorolac, lansoprazole, latanoprost, levobunolol, levofloxacin, levorphanol, lithium carbonate, lithium citrate, loperamide, loracarbef, loratadine, loratadine/pseudoephedrine, lorazepam, loteprednol, loxapine, magnesium sulfate, medrysone, mesoridazine, metaproterenol, methadone, methylphenidate, metipranol, metoclopramide, metronidazole, minocycline, mirtazapine, misoprostol, molindone, mometasone, montelukast, morphine sulfate, mupirocin, mydriatic combinations, naphazoline w/wo combinations, naproxen, nedocromil, nefazodone, neomycin w/wo/ combinations, nitrofurantoin, nizatidine, nortriptyline, octreotide, olanzapine, omeprazole, ondansetron, opium (tincture), oxazepam, oxtriphylline, oxybutynin, oxycodone w/wo/ ASA, APAP, pancreatic enzymes, paregoric, paroxetine, pemoline, penicillin G, penicillin V potassium, pentobarbital, perphenazine, phenir/ppa/phenylt./pyrilamine, phenylprop/pyril/pheniramine, phenyltolox/APAP, phenyltolox/pyril/pheniramine, phenytoin, pilocarpine, pilocarpine w/ epinephrine, pirbuterol, piroxicam, podofilox, prazepam, prednisolone, prednicarbate, primidone, probenecid, prochlorperazine, progestins, prometh/phenylephrine, promethazine, quetiapine fumarate, ranitidine, rimexolone, risperidone, salmeterol, scopolamine, secobarbital, sertraline, sparfloxacin, spectinomycin, sucralfate, sulfacetamide sodium/prednisolone, sulfasalazine, sulindac, suprofen, temazepam, terbutaline, tetracycline, theophylline, thiethylperazine, thioridazine, thiothixene, ticarcillin/clavulanate, timolol, tobramycin, tolmetin, tolterodine, tramadol, trazodone, triamcinolone acetonide, triazolam, triamcinolone, trifluoperazine, trimethobenzamide, trimipramine, tripelennamine, triprolidine hcl/pseudo, tromethamine, tropicamide, vancomycin, valproic acid, venlafaxine, zafirlukast, zileuton, zolpidem.

ADAP FORMULARIES North Carolina ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), clarithromycin (Biaxin), famciclovir (Famvir), fluconazole (Diflucan), ganciclovir (Cytovene), itraconazole (Sporonox), leucovorin, pyrimethamine (Daraprim), sulfadiazine, TMP/SMX (Bactrim, Cotrim, Septra, Sulfatrim). Other OIs- atovaquone (Mepron), ciprofloxacin (Cipro), clindamycin (Cleocin), dapsone, ethambutol (Myambutol), ketoconazole (Nizoral), nystatin (Mycostatin, Nilstat), paromomycin (Humatin), pentamidine (NebuPent), rifabutin (Mycobutin), valacyclovir (Valtrex), valganciclovir (Valcyte). Hepatitis C- none. ALL OTHERS amitriptyline (Elavil), diphenoxylate (Lomotil), lansoprazole (Prevacid), loperamide (Imodium), nortriptyline (Pamelor), omeprazole (Prilosec), ondansetron (Zofran), pancrelipase (Pancreas), prochlorperazine (Compazine), promethazine (Phenergan).

North Dakota ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), cidofovir (Vistide), clarithromycin (Biaxin), famciclovir (Famvir), fluconazole (Diflucan), foscarnet (Foscavir), ganciclovir (Cytovene), itraconazole (Sporonox), leucovorin (Wellcovorin), pyrimethamine (Daraprim), sulfadiazine, TMP/SMX (Bactrim, Septra). Other OIs- albendazole (Albenza), amphotericin B (Fungizone), amoxicillin (Amoxil), atovaquone (Mepron), ciprofloxacin (Cipro), clindamycin (Cleocin), clotrimazole (Lotrimin, Mycelex), dapsone, erythromycin (Erythrocin, Ery-Tab, EES), erythropoietin (Epogen, EPO, Procrit), ethambutol (Myambutol), filgrastim (G-CSF, Neupogen), ketoconazole (Nizoral), nystatin (Mycostatin), paromomycin (Humatin, Aminosidine, AMS), pentamidine (NebuPent, Pentam, Pentacarinat), prednisone (Deltasone, Meticorten, Orasone), rifabutin (Mycobutin). Hepatitis C- none. TREATMENTS FOR METABOLIC DISORDERS Cardiac- doxazosim mesylate (Cardura), lisinopril (Zestril). Hyperlipidemia- atorvastatin (Lipitor). Wasting- dronabinol (Marinol), megestrol acetate (Megace). ALL OTHERS acetaminophen/codine (Tylenol #3), amantadine (Symmetrel), amitriptyline (Elavil), calcium acetate (PhosLo), chlor-hexidene (Peridex), diphenoxylate w/atropine (Lomotil), fludrocortisone (Florinef), fluoxetine (Prozac), gabapentin (Neurontin), haloperidol (Haldol), hepatitis B vaccine, influenza vaccine, loperamide (Imodium), lorazepam (Ativan), morphine (Duramorph, Oramporph, Roxanol), morphine sulfate (MS Contin), olanzapine (Zyprexa), pantoprazole sodium (Protonix), pneumococcal vaccine, prochlorperazine (Compazine), propoxyphene N-100 (Darvocet), ranitideine(Zantac), sertraline (Zoloft), trazodone (Desyrel), venlafaxine (Effexor), vitamin (Nephrocap), zanamivir (Relenza).

Ohio ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx, Videx EC), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), clarithromycin (Biaxin), fluconazole (Diflucan), pyrimethamine (Daraprim), TMP/SMX (Bactrim). Other OIs- clotrimazole (Mycelex), dapsone, ethambutol (Myambutol), ketoconazole (Nizoral), nystatin (Nilstat), pentamidine (Pentam), rifabutin (Mycobutin). Hepatitis C- none.

Oklahoma

ADAP FORMULARIES

ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), clarithromycin (Biaxin), fluconazole (Diflucan), itraconazole (Sporonox), TMP/SMX (Bactrim, Septra). Other OIs- dapsone, pentamidine (NebuPent, Pentam), rifabutin (Mycobutin). Hepatitis C- none.

Oregon ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), cidofovir (Vistide), clarithromycin (Biaxin), famciclovir (Famvir), fluconazole (Diflucan), foscarnet (Foscavir), ganciclovir (Cytovene), isoniazid (Nydrazid, Rifamate, Rifater), itraconazole (Sporonox), leucovorin, pyrazinamide (Rifater), pyrimethamine (Daraprim, Fansidar), rifampim (Rifamate, Rifater, Rifadin, Rimactane), sulfadiazine, TMP/SMX (Bactrim, Cotrim, Septra). Other OIs- amikacin, atovaquone (Mepron), ciprofloxacin (Cipro), clindamycin (Cleocin, Clinda-Derm), clotrimazole (Mycelex), cycloserine (Seromycin), dapsone, daunorubicin (DaunoXome), doxorubicin (Adriamycin, DOXIL, Rubex), epoetin alfa (Epogen, Procrit), ethambutol (Myambutol), ethionamide (Trecator), fomivirsen sodium IV (Vitravene), filgrastim (Neupogen), ketoconazole (Nizoral), metronidazole (Flagyl), ofloxacin (Floxin), para aminosalicyclic acid (PAS), pentamidine (Nebupent), rifabutin (Mycobutin), streptomycin, trimetrexate glucuronate (Neutrexin), valacyclovir (Valtrex). Hepatitis C- Interferon alfa 2a,2b (Intron A, RoferonA). TREATMENTS FOR METABOLIC DISORDERS Diabetic- acarbose (Precose), chlorpropamide (Diabinese), metformin HCI (Glucophage), glimepride (Amaryl), glipizide (Glucotrol), glyburide (DiaBeta, Glynase, Micronase), insulins (all insulins). Hyperlipidemia- atorvastatin (lipitor), clofribate (Atromid), gemfibrozil (Lopid), fluvastatin (Lescol), lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor). Wasting- dronabinol (Marinol), megestrol acetate (Megace), nandrolone decanoate (Deca-Durabolin), oxandrolone (Oxandrin), testosterone cypionate (Birilon IM), testerone enanthate (Delatestryl), thalidomide. ALL OTHERS acetaminophen (various), alfentanil (Alfenta), alglucerase (Ceredase), alteplase (Activase), amitriptyline (Elavil, Etrafon, Triavil, Limbitrol), amoxapine (Asendin), amoxicillin (Amoxil, Wymox), amoxicillin/calvulanate potassium (Augmentin), ampicillin sodium/sulbactam sodium (Unasyn), Arco-Lase Plus, asparaginase (Elspar), aspirin (Easprin), buprenorphine (Buprenex), buproprion (Wellbutrin), buspirone (Buspar), butalbital (Various), carbamezapine (Atretol, Tegretol, Epitol), cefazolin sodium (Ancef, Kefzol), chlordiazepoxide (Limbitrol), choline (Trilisate), clonazepam (Klonopin), clorazepate (Tranxene, Gen-xene), codine (Various), desipramine (Norpramin), dezocine (Dalgan), diazepam (Dizac, Balium), diclofenac (Cataflam, Voltaren), difenoxin HCI (Motofen), diflunisal (Dolobid), dihydrocodeine (DHCplus, Synalgos), diphenoxylate HCI (Lomotil), disoium/clavulanate potassium (Timentin), doxepin (Adapin, Sinequan, Zonalon), doxycycline calcium (Vibramycin Calcium), enoxacin (Penetrex), erythromycin (all forms), ethosuximide (Zarontin), ethotoin (Peganone), etodolac (Lodine), felbamate (Felbatol), fenoprofen (Nalfon), fentanyl (Duragesic, Sublimaze), fluoxetine (Prozac), fosphenytoin (Cerebyx), furazolidone (Furoxone), gabapentin (Neurontin), gentamicin (Garamycin, G-myticin), hepatitis A vaccine, hepatitis B vaccine, h. influenza B vaccine, hydrocodone (Various), hydromorphone (Dilaudid), ibuprofen (IBU, Motrin), imiglucerase (Cerezyme), imipramine (Tofranil), indomethacin (Indocin), influenza vaccine, ketoprofen (Orudis, Oruvail), ketorolac (Toradol), lamotrigine (Lamictal), levofloxacin (Levaquin), levomethadyl (Orlaam), levorphanol (LevoDromoran), lomefloxacin HCI (Maxaquin), loperamide HCI (Imodium), maprotiline (Ludiomil), meclizine (Antivert), mefenamic (Ponstel), meperidine (Demerol, Mepergan), mephenytoin (Mesantoin), mephobarbital (Mebaral), methadone (Dolophine), methotrimeprazine (Levoprome), methasuximide (Celontin), midrin, mirtazipine (Remeron), MMR (measles, mumps, rubella), morphine (various), nabumetone (Relafen), nalbuphine (Nubain), naproxen (Anaprox, Naprelan), nefazodone (Serzone), nortriptyline (Pamelor), octreotide acetate (Sandostatin), ondansetron HCI (Zofran), opium (Tincture), orphenadrine (Norflex, Norgesic, Mio-Rel), oxaprozin (Daypro), oxycodone (Various), oxymorphone (Numorphan), paroxetine (Paxil), penicillin (Pen-Vee K), pegademase (Adagen), pegaspargase (Oncaspar), pentazocine (Talacen, Talwin), pentobarbital (Nembutal), perphenazine (Etrafon,Triavil), phenacemide (Phenurone), phenelzine (Nardil), phenobarbital, phenytoin (Dilantin), primidone (Mysoline), piroxicam (Feldene), pneumococcal (Pneumovax), polio vaccine, prochlorperazine (Compazine), promethazine HCI (Phenergan), propoxyphene (Darvocet, Darvon, Wygesic), protriptyline (Vivactil), salsalate (Disalcid, Mono-Gesic, Salflex), sertraline (Zoloft), sufentanil (Sufenta), sulindac ( Clinoril), tetanus-diptheria vaccine, ticarcillin, tolmetin (Tolectin), tramadol (Ultram), tranylcypromine (Parnate), traumeel, trazodone (Desyrel), trimethobenzamide HCI (Tigan), trimipramine (Surmontil), trovofloxacin (Trovicin), valproic acid (Depakene), varicella vaccine, venlaxafine (Effexor).

ADAP FORMULARIES Pennsylvania ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). OI DRUGS PHS “A1 OI”s- acyclovir, azithromycin, clarithromycin (Biaxin), fluconazole, foscarnet (Foscavir), ganciclovir, isoniazid, itraconazole, leucovorin, pyrazinamide, pyrimethamine, rifampim, sulfadiazine, TMP/SMX (Bactrim, Septra). Other OIs- amikacin, amphotericin B, atovaquone (Mepron), bleomycin, capreomycin, ciprofloxacin, clindamycin, clofazimine, clotrimazole, cycloserine, dapsone, dexamethasone, doxorubicin, ethambutol, ethionamide, etoposide, flucytosine, kanamycin sulfate, ketoconazole, nystatin, ofloxacin, paromomycin sulfate, pentamidine, prednisone, primaquine phosphate, rifabutin, sulfadoxine & pyrimethamine, terconazole, trimetrexate glucuronate (Neutrexin), triple sulfa, vinblastine sulfate, vincristine sulfate, valacyclovir. Hepatitis C- alpha interferon. TREATMENTS FOR METABOLIC DISORDERS Wasting- dronabinol (Marinol), megestrol acetate (Megace).

Puerto Rico ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), clarithromycin (Biaxin), famciclovir (Famvir), fluconazole (Diflucan), foscarnet (Foscavir), ganciclovir (Cytovene), isoniazid (INH), itraconazole (Sporanox), leucovorin, pyrazinamide (PZA), pyrimethamine (Daraprim), rifampin (Rifadin), sulfadiazine, TMP/SMX (Septra). Other OIs- amikacin (Amikin), amphotericin B (Fungizone), atovaquone (Mepron), capreomycin (Capastat), ciprofloxacin (Cipro), clindamycin (Cleocin), clofazimine (Lamprene), clotrimazole (Lotrimin, Mycelex), cycloserine (Sermycin), dapsone, epoetin alfa (Procrit), ethambutol (Myambutol), ethionamide (Trecator SC), filgrastim (Neupogen), IVIG (Gamimune-N, Gammagard), kanamycin (Kantrex), ketoconazole (Nizoral), metronidazole (Flagyl), nystatin (Mycostatin), ofloxacin (Floxin), para aminosalicyclic acid (Paser), paromomycin (Humatin), pentamidine (NebuPent, Pentam), rifabutin (Mycobutin), triple sulfa, valacyclovir (Valtrex). Hepatitis C- interferon alfa 2b (Intron A). TREATMENTS FOR METABOLIC DISORDERS Wasting- megestrol acetate (Megace), ALL OTHERS acetaminophen (Tylenol), albuterol (Proventil), amytriptyline (Elavil), amoxicillin (Trimox), amoxicillin/clavulanate (Augmentin), antacids (Mylanta, Maalox), betamethasone dipropionate (Diprolene), betamethason/clotrimazole cream (Lotrisone), capsaicin (Zostrix), cefadroxil (Duricef), ceftriaxone (Rocephin), cetirizine (Zyrtec), clindamycin vaginal cream (Cleocin), clotrimazole vaginal cream (Gyne-Lotrimin), cold cream (generic), diphenhydramine (Benadryl), doxycycline (Vibramycin), econazole nitrate (Spetazole), erythromycin base (PCE), flurbiprofen (Ansaid), fluocinonide (Synalar), fluoxetine (Prozac), guaifensin / oxtriphyline (Brondelate), guaifenesin / phenylephrine (Albatussin SR, NN), hydrocortisone cream, hydroxyzine pamoate, ibuprofen (Motrin), imiquimod (Aldara), Ionil-T shampoo, ketaconazole shampoo, Ku-Zyme (amylase, cellullase, lipase, protease), lanzoprazole (Prevacid), lidocaine HCI (Emla Cream, Xylocaine), lindane shampoo/lotion, loperamide (Imodium), loratidine (Claritin), metronidazole vaginal cream (Metrogel), mometasone (Elocon), Neosporin, Nutraderm lotion, penicillin G benzathine (Bicillin LA), podophyllin, pseudoephedrine / triprolidine (Actifed), ranitidine (Zantac), sertraline HCI (Zoloft), spectomycin (Trobicin), sucralfate (Carafate), terbenafine (Lamisil), terconazole vaginal cream (Terazol), triamicinolone (Kenalog), tricloric acid, tubercullin (Tubersol), vitamins and minerals (Albafort, Alba-Lybe, ferrous sulfate, Folinic Acid, Iberet folic, Nervidox, Piridoxina, Tia-Doce, Unicap)

ADAP FORMULARIES Rhode Island ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (generic). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), clarithromycin (Biaxin), fluconazole (Diflucan), ganciclovir (Cytovene), isoniazid, itraconazole (Sporonox), leucovorin (Folinic Acid), pyrimethamine, sulfadiazine, TMP/SMX (Bactrim, Septra). Other OIsatovaquone (Mepron), ciprofloxacin (Cipro), dapsone, ethambutol (Myambutol), pentamidine (Nebupent), rifabutin (Mycobutin), valacyclovir (Valtrex). Hepatitis C- interferon alpha (Intron A). ALL OTHERS amitriptyline, citalopram (Celexa), clonazepam, fentanyl patch (Duragesic), fluoxetine (Prozac), lorazepam, MS Contin (200 mg only), gabapentin (Neurontin), olanzapine (Zyprexa), Oramorph SR, Oxycondone/r-Oxycondone, Oxycontin, paroxetine (Paxil), risperidone (Risperdal), trazodone, sertraline (Zoloft).

South Carolina ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx, Videx EC), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Apothecon), azithromycin (Zithromax), clarithromycin (Biaxin), famciclovir (Famvir), fluconazole (Diflucan), itraconazole (Sporonox), leucovorin (Folinic Acid), pyrimethamine (Daraprim), sulfadiazine, TMP/SMX (generics Bactrim, Septra). Other OIs- atovaquone (Mepron), clindamycin (Cleocin), clotrimazole (Mycelex), dapsone, ethambutol (Myambutol), ketoconazole (Nizoral), nystatin (Geneva), primaquine, rifabutin (Mycobutin), valacyclovir (Valtrex). Hepatitis C- none.

South Dakota ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx, Videx EC), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), clarithromycin (Biaxin), famciclovir (Famvir), fluconazole (Diflucan), itraconazole (Sporonox), leucovorin, pyrimethamine (Daraprim), TMP/SMX (Septra). Other OIs- atovaquone (Mepron), ciprofloxacin (Cipro), clofazimine (Lamprene), clotrimazole (Mycelex), dapsone, paromomycin (Humatin), pentamidine (NebuPent), rifabutin (Mycobutin), valacyclovir (Valtrex). Hepatitis C- none. TREATMENTS FOR METABOLIC DISORDERS Wasting- megestrol acetate (Megace). ALL OTHERS acetaminophen/codine, amitriptyline (Elavil), divalproex sodium (Depakote), fentanyl (Duragesic), morphine, MS Contin, phenytoin (Dilantin), prochlorperazine (Compazine), propoxyphene (Darvocet).

ADAP FORMULARIES Tennessee ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx, Videx EC), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), clarithromycin (Biaxin), fluconazole (Diflucan), itraconazole (Sporonox), leucovorin, pyrimethamine (Daraprim), rifampim, sulfadiazine, TMP/SMX (Bactrim). Other OIs- clindamycin, dapsone, erythropoietin (Procrit), ethambutol (Myambutol), filgrastim (Neupogen), metronidazole (Flagyl), nystatin, paromomycin (Humatin), pentamidine (IV, NebuPent), promethazine HCI (Phenergan), rifabutin (Mycobutin). Hepatitis C- none. TREATMENTS FOR METABOLIC DISORDERS Wasting- megestrol acetate (Megace). ALL OTHERS Pediatric formulations of HIV drugs are available for the following: amprenavir (Agenerase), lamivudine (3TC, Epivir), didanosine (ddI, Videx), zidovudine (AZT, Retrovir), ritonavir (Norvir), lopinavir/ritonavir (Kaletra), atovaquone (Mepron), megestrol acetate (Megace). Note: In addition, the following medicines are available through the Medical Services Fee Schedule: amphotericin B, ceftraxione (Rocephin), cosyntropin (Cortrosyn), foscarnet (Foscavir), ganciclovir, vancomycin.

Texas ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), clarithromycin (Biaxin), fluconazole (Diflucan), ganciclovir (Cytovene), itraconazole (Sporonox), TMP/SMX (Bactrim). Other OIs- amphotericin B, atovaquone (Mepron), dapsone, ethambutol (Myambutol), IVIG (Pediatric only), pentamidine (Nebupent), rifabutin (Mycobutin), trimethoprim. Hepatitis C- interferon alpha (Roferon A). TREATMENTS FOR METABOLIC DISORDERS Wasting- megestrol acetate (Megace).

Utah ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea).

ADAP FORMULARIES Vermont ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx, Videx EC), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), cidofovir (Vistide), clarithromycin (Biaxin), famciclovir (Famvir), fluconazole (Diflucan), foscarnet (Foscavir), itraconazole (Sporonox), leucovorin (Wellcovorin), pyrimethamine (Daraprim), sulfadiazine, TMP/SMX (Bactrim, Septra). Other OIs- amphotericin B (Fungizone), atovaquone (Mepron), ciprofloxacin (Cipro), clindamycin (Cleocin), clotrimazole (Lotrimin, Mycelex), dapsone, doxorubicin liposomal (DOXIL), ethambutol (Myambutol), filgrastim GCSF (Neupogen), ketoconazole (Nizoral), nystatin (Mycostatin), pentamidine (NebuPent, Pentam), primaquine, rifabutin (Mycobutin), trimethoprim, valganciclovir (Valcyte). Hepatitis C- none. TREATMENTS FOR METABOLIC DISORDERS Hyperlipidemia- artovastatin (Lipitor), fluvastatin (Lescol), gemfibrozil (Lopid), lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor), Wasting- megestrol acetate (Megace). ALL OTHERS amitriptyline (Elavil), buproprion (Wellbutrin / SR), citalopram (Celexa), fentanyl (Duragesic), fluoxetine (Prozac), gabapentin (Neurontin), ibuprofen (Motrin), loperamide (Imodium), morphine sulfate (MS Contin), nefazadone (Serzone), paroxetine (Paxil), polycarbophil (Fibercon), psyllium (Metamucil), sertraline (Zoloft), trazodone (Desyrel), venlaxafine (Effexor).

Virgin Islands ANTIRETROVIRALS NRTIs- abacavir (Ziagen), didanosine (ddI, Videx, Videx EC), lamivudine (Epivir, 3TC), stavudine (d4T, Zerit), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). OI DRUGS PHS “A1 OI”s- azithromycin, fluconazole, TMP/SMX (Bactrim DS). Other OIs- ketoconazole cream, valacyclovir. Hepatitis C- none.

Virginia ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), cidofovir, clarithromycin (Biaxin), fluconazole (Diflucan), foscarnet (Foscavir), ganciclovir (Cytovene), itraconazole (Sporonox), leucovorin, TMP/SMX (Bactrim, Septra). Other OIs- atovaquone (Mepron), dapsone, ethambutol (Myambutol), pentamidine, rifabutin (Mycobutin), trimethoprim. Hepatitis C- none.

ADAP FORMULARIES Washington ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), cidofovir (Vistide), clarithromycin (Biaxin), famciclovir (Famvir), fluconazole (Diflucan), foscarnet (Foscavir), ganciclovir (Cytovene), itraconazole (Sporonox), leucovorin, pyrimethamine (Daraprim, Fansidar), rifampim (Rifadin), sulfadiazine (Microsulfon), TMP/SMX (Bactrim, Septra, CoTrim). Other OIs- albendazole, atovaquone (Mepron), ciprofloxacin (Cipro), clindamycin, clofazimine (Lamprene), clotrimazole (Lotrimin, Mycelex), dapsone, ethambutol (Myambutol), ketoconazole (Nizoral), metronidazole (Flagyl, Metrogel), miconazole, nystatin, oflaxacin, paromomycin (Humatin), pentamidine (NebuPent), primaquine, rifabutin (Mycobutin), terconazole (Terazol), trimethoprim, valacyclovir (Valtrex), valganciclovir. Hepatitis C- none. TREATMENTS FOR METABOLIC DISORDERS Diabetic- acarbose (Precose), insulin, injection kits, glucose test strips, glipizide (Glucotrol), glyburide (DiaBeta), metformin (Glucophage), pioglitazone (Actos), repaglinide (Prandin), rosiglitazone (Avandia). Hyperlipidemia- atorvastatin (Lipitor), cholestyramine (Questran), gemfibrozil (Lopid), lovastatin (Mevacor), niacin, pravastatin (Pravachol), simvastatin (Zocor), Wasting- dronabinol (Marinol), megestrol acetate (Megace), testosterone. ALL OTHERS aciphex (Raberprazole), amoxicillin, amoxicillin/potassium (Augmentin), ampicillin, carbamazepine (Tegretol), cefixime (Suprax), ceftriaxone, cephalexin (keflex), cimetidine, clotrimazole / betamethasone (Lotrisone cream), clozapine (Clozaril), dicloxacin, diphenoxylate / atropine (Lomotil), divalproex Sodium (Depakote), doxyclcline, erythromycin, estrogen (Premarin), famotidine (Pepcid), gabapentin (Neurontin), Hep B Immune Globulin, Imiquimod cream, Immune Globulin IM (IGIM), lamotrigine (Lamictal), lindane, lithium, loperamide (Imodium), Mediset fills, medroxyprogesterone (Depo-Provera), metoclopramide (Reglan), nexium (Espmeprazole), nizatidine (Axid), olanzapine (Zyprexa), ondansetron (Zofran), opium, tincture of, oxcarbazepine (Trileptal), penicillin, peridex, permethrin, phenazopyridine (Pyridin, Pyridium), podofilox (Condylox), prevacid (Lansoprazole), prilosec (Omeprazole), prochlorperazine (Compazine), promethazine (Phenergan), protonix (Pantoprazole), ranitidine (Zantac), risperidone (Risperdal), selenium sulfide, tetracycline, topical steroids -all drugs in the class, topiramate (Topamax), valproic acid (Depakene), vancomycin oral, VZIG (Varicella Zoster Immune Globulin). The following classes of drugs are covered as groups. A drug’s class is defined by the medical community and endorsed by the federal Food and Drug Administration. Analgesic - oral only (e.g.) NSAIDs, Narcotics. Antianxiety - (e.g.)buspirone (Buspar), clonazepam (Klonopin), diazepam (Valium), hydroxyzine (Vistaril), lorazepam (Ativan). Antidepressant - (e.g.)amitriptyline (Elavil), bupropion (Wellbutrin), citalopram (Celexa), clomipramine (Anafranil), desipramine, doxepin, fluoxetine (Prozac), fluvoxamine (Luvox), imipramine, nefazodone (Serzone), nortriptyline, paroxetine (Paxil), sertraline (Zoloft), trazodone, venlafaxine (Effexor).

West Virginia ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). OI DRUGS PHS “A1 OI”s- azithromycin (Zithromax), TMP/SMX (Bactrim). Other OIs- clotrimazole (Mycelex), dapsone, ketoconazole (Nizoral), nystatin (Mucostatin), pentamidine (NebuPent, Pentam). Hepatitis C- none.

ADAP FORMULARIES Wisconsin ANTIRETROVIRALS NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx, Videx EC), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), clarithromycin (Biaxin), fluconazole (Diflucan), ganciclovir (Cytovene), itraconazole (Sporonox), leucovorin (Wellcovorin), pyrimethamine (Daraprim), sulfadiazine, TMP/SMX (Bactrim, Septra). Other OIsamphotericin B (Fungizone), atovaquone (Mepron), clindamycin (Cleocin), dapsone, ganciclovir implant (Vitrasert), ketoconazole (Nizoral), pentamidine (NebuPent), rifabutin (Mycobutin). Hepatitis C- none.

Wyoming ANTIRETROVIRALS NRTIs- abacavir (Ziagen), didanosine (ddI, Videx), lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). OI DRUGS PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), clarithromycin (Biaxin), fluconazole (Diflucan), foscarnet (Foscavir), ganciclovir (Cytovene), isoniazid, itraconazole (Sporonox), leucovorin (Wellcovorin), pyrazinamide (Terbrazid), pyrimethamine (Fansidar), rifampim (Rifadin, Rifamate), sulfadiazine (Microsulfon), TMP/SMX (Bactrim, Septra). Other OIs- amikacin (Amikin), amphotericin B (Fungizone), atovaquone (Mepron), bleomycin (Blenoxane), ciprofloxacin (Cipro), clindamycin (Cleocin), clofazimine (Lamprene), clotrimazole (Lotrimin, Mycelex), dapsone, doxorubicin (Adriamycin), erythropoietin (Epogen, Procrit), ethambutol (Myambutol), filgrastim (Neupogen), interferon n3, Beta, Gamma (Alferon N, Betaseron, Actimmune), ketoconazole (Nizoral), metronidazole (Flagyl), nystatin, paromomycin (Humatin), pentamidine (Pentam), prednisone (Deltasone), primaquine, rifabutin (Mycobutin), streptomycin, terconazole (Terazol), vinblastine (Velban), vincristine (Oncovin), valacyclovir (Valtrex). Hepatitis C- interferon 2a, 2b (Roferon A, Intron A). TREATMENTS FOR METABOLIC DISORDERS Hyperlipidemia- atorvastatin (generic), simvastatin (generic), fenofibrate (Tricor). Wasting- dronabinol (Marinol), megestrol acetate (Megace). ALL OTHERS amoxicillin,amoxicillin/clavulante (Augmentin), bupropion (Wellbutrin), carbamezapine (Tegretol), cephalexin, cefprozil (Procef, Prozef, Cefzil), doxycycline, famotidine (Pepcid), fluoxetine (Prozac), ibuprofen (Motrin, Advil), lansoprazole (Prevacid), levofloxacin (Levaquin), morphin sulfate (MS Contin/Roxanol), norfloxacin (Norflox), paroxetine (Paxil), penicillin, phenytoin (Dilantin), sertraline (Zoloft), sulfacetamide, trifluridine (Viroptic), valproic acid (Depakene, Depakote). Secondary Forumulary ( all generics) : acetaminophen combinations, alprazolam, amantadine, amitriptyline, amoxapine, aspirin combinations, birth control pills and injection, bronfenac, buspirone, chlorpromazine, choline magnesium trisalicylate, choline salicylate, citalopram, clozapine, clomipramine, codeine, desipramine, diazepam, diphenoxylate/altropine (generic), doxepin, etodolac, fenoprofen, fentanyl, fluphenazine, fluvoxamine, guafenisin, haloperidol, hydromorphone, hydroxyzine ibuprofen, imipramine, imiquimod cream (generic), indomethacin, Kao-Pectate (generic), ketoprofen, ketorolac, lidocaine viscus sol/gel, lithium, loperamide (generic), lorazepam, loxapine, maprolitine, meclofenamate, mefenamic, meperidine,, methadone, mirtazapine, morphine, nabumetone, naproxen, nefazodone, nortriptyline, olanzapine, omeprazole, oxaprozin, oxazepam, oxycodone, perphenazine, phenelzine, piroxicam, prochlorperazine, promazine, propoxyphene, protriptyline, psyllium, quetipine, relenza, rimatadine, risperidone, salsalate, sertindole, sulindac, tamiflu, thioridazine, thiothixene, tolmetin, topical corticosteroids, tranycypromine, trazodone, trifluoperazine, trimipramine, venlaxafine.

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