June 9, 2003

Dear State Health Officials:

We are writing to offer our support for the ADAP Crisis Task Force in their on-going price negotiations with companies that produce anti-HIV drugs. The ADAP Crisis Task Force has been negotiating with antiretroviral manufacturers for additional ADAP rebates for all state ADAP programs.

It is our understanding that GlaxoSmithKline (one of three companies that has not completed negotiations), has been approaching states individually in an attempt to circumvent the work of Task Force by making separate state-by-state deals that could leave some state ADAPs with no relief. The central premise for the work of the task force was that each company had to make one agreement that would cover all state ADAP programs to insure equity. We ask, therefore, that you refuse to negotiate on an individual state basis and, instead, support the goals of the Task Force by allowing them to continue negotiations as a group, so that all ADAPs across the country can benefit equally from the resulting price discounts.

Many of us in the AIDS community have been critical of the pharmaceutical industry's pricing practices, both domestically and internationally. We firmly believe these life-saving medications must be made available to those who need them. We vocally protested when new drug prices were set outrageously high. We demanded and received price freezes when the pharmaceutical industry continued to raise prices at twice the annual rate of inflation. We know all too well what happens when people who need treatment get turned away. HIV infection is not only a health crisis. It is also a life crisis. Access to treatment and care is essential to allowing People with HIV to deal with the crisis on solid ground. Without necessary medications, many would surely progress towards morbidity and mortality needlessly.

Indeed, the AIDS Drug Assistance Program has been an essential response to the AIDS crisis. ADAP was there when the first protease inhibitors came out, giving those who could not afford combination therapy a chance to fight this disease. For several years, ADAPs have been reasonably able to keep pace with increases in enrollment and cost. However, given the current economic downturn, it has been increasingly difficult to garner support for adequate ADAP funding at either the federal or state level. Medicaid cuts across the nation and the CDC's Rapid Testing Initiative are both likely to further increase demand for ADAP services and the need for additional funding to meet those demands. The ADAP infrastructure took over ten years to build. Now is not the time to allow this successful model which benefits the working poor to be destroyed.

We applaud the ADAP Crisis Task Force for taking the initiative to negotiate further price discounts for all ADAPs. With the projected $145 million shortfall for the current ADAP fiscal year, and a projected $283 million shortfall for FY 04, the industry, as the recipient of all but a small fraction of the over $800 million spent through ADAP each year, must pitch in and do their share to assist this program to meet the needs of all ADAP clients who depend on the program for their HIV medications. We believe that the Industry must do its part to help avert this growing public health disaster by partnering with government and contributing additional rebates and continuing price freezes.

By negotiating as one, all ADAPs benefit from both combined buying power and the preferred treatment that should be afforded a major customer. ADAP is unique among publicly funded programs in that it already utilizes both formulary management and the 340-B pricing program as tools for obtaining the best possible prices from industry. By joining forces, the Task Force has taken negotiations one very important step further. This will not only create better drug prices in the short term, but will also have long term effects on the industry's pricing practices, in the setting of new drug prices, and in raising prices of older drugs.

Once again, we urge you to reject GlaxoSmithKline's offer to your state. Instead, we ask that you demand that they return to good faith negotiation with the Crisis Task Force. The AIDS Community will be doing our part to press for the company's return to the table with a serious offer. The lives of people living with HIV/AIDS, and your state's budget, depends on your ability to stand firm at this critical juncture.

Thank you for your attention to this matter,

Sincerely,

Organizations:
ActionAIDS, Philadelphia, Pennsylvania
ACT UP Atlanta, Georgia
ACT UP/Cleveland, Ohio
ACT UP East Bay, Oakland, California
ACT UP/Louisiana
ACT UP/New York
ACT UP/Philadelphia
AIDS ACTION, Washington DC
AIDS Action Baltimore, Maryland
AIDS Education Global Information System (AEGIS)
The AIDS Policy Project, Philadelphia, Pennsylvania
AIDS Project Los Angeles, California
AIDS Project Rhode Island
AIDS ReSearch Alliance, West Hollywood, California
AIDS Survival Project, Atlanta, Georgia
AIDS Taskforce of Greater Cleveland, Ohio
AIDS Task Force of the Upper Ohio Valley, Wheeling, West Virginia
AIDS Treatment Activists Coalition (ATAC)
AIDS Treatment Activists Coalition/ATAC Drug Development Committee
AIDS Treatment Activists Coalition/ATAC Save ADAP Committee
AIDS Treatment Data Network, New York
AIDS Vaccine Advocacy Coalition (AVAC), New York
Being Alive Long Beach, California
Being Alive: People With HIV/AIDS Action Coalition of Los Angeles, California
Betances Health Center, New York
Cambridge Cares About AIDS, Inc., Massachusetts
CARES, HIV/AIDS healthcare center for Sacramento and inland northern California
The Center for AIDS: Hope & Remembrance Project, Houston, Texas
The Circle of Friends, Lenoir County AIDS Task Force, Kinston, North Carolina
Community HIV/AIDS Mobilization for Power (CHAMP), Philadelphia, Pennsylvania
DIVA TV, New York City
Embrace Life, Natural Solutions for Immune Strengthening, Capitola, California
Florida AIDS Action
Florida Keys HIV Community Planning Partnership, Monroe County, Florida
FRIENDS Alliance, Warren, Michigan
The Foundation for Integrative AIDS Research (FIAR), Brooklyn, New York
Gay & Lesbian Medical Association, San Francisco, California
Gay Men's Health Crisis, New York, New York
HIV Advocacy Council of OR/SWWA, Portland, Oregon
HIVCare, Saint Francis Memorial Hospital, San Francisco, California
HIV Consumer Rights Advocacy Project, San Francisco, California
HIV/Hepatitis C in Prison Committee of California Prison Focus
Housing Works, Inc. New York, New York
Hyacinth AIDS Foundation, New Jersey
International Foundation for Alternative Research in AIDS (IFARA), Portland, Oregon
Iris House, Inc., New York, New York
Jersey City Connections, inc. a/k/a HudsonPride, New Jersey
Medical Advocates for Social Justice, Illinois
Michigan Advocates Exchange, Inc.
Miriam Hospital ACTU Community Aivisory Board, Providence, Rhode Island
Nashville CARES, Nashville, Tennessee
National Association for Victims of Transfusion-Acquired AIDS
National Association of People With AIDS (NAPWA)
National Minority AIDS Council (NMAC)
Northwest Coalition for AIDS Treatment in Africa
NYC AIDS Housing Network, New York
Parkland HIV/AIDS Department, Texas
Positives For Positives, Wyoming
Project Inform, San Francisco, California
Provincetown AIDS Support Group, Massachusetts
San Francisco AIDS Foundation, California
SPECIAL AUDIENCES, Inc., Newark, New Jersey
Stanislaus County Health Services Agency, AIDS Case Management, Modesto, California
Survive AIDS, California
Tennessee AIDS Support Services, Inc.
Test Positive Aware Network, Chicago, Illinoise
TII CANN-Title II Community AIDS National Network, Washington, DC
Treatment Action Group , New York
Triad Health Project, Greensboro, North Carolina

Individuals:
Melissa Abdullah, Yonkers, New York
Maura Armsworthy, Cambridge, Massachusetts
Patricia A. Bartlett, Durham, North Carolina
Mark Beauchamp, Michigan
Juliette Bloxham, Capitola, California
Steven Bromer, MD, Guerneville, California
Monica T. Brown, North Carolina
Donna Budde, North Carolina
George E Burgess, Atlanta, Georgia
Kristina Butler, Greensboro, North Carolina
Russ Candler, Atlanta, Georgia
Debra Cary, ACRN, Providence, Rhode Island
Don Cavellini, Greenville, North Carolina
Jacqueline S. Clements, North Carolina
Merrill Cole, Ph.D. & Jeffrey L. Stuckey, Domestic Partners, Kentucky
Chris Collins, New York
Jen Curry, California
Jay Dagenhart, Philadelphia, Pennsylvania
Kristine Davis ARNP, Cedar Rapids, Iowa
Alicia Dithmart, Clinton, Iowa
Michele Douglas, Baltimore, Maryland
Alan Drucker, M.D., Fresno, California
Scott Douglas England, California
Moriah Evans, New York and Ohio
Amy Faw, Greensboro, North Carolina
Lee C. Fischer, Baltimore, Maryland
Thomas Gegeny, Houston, Texas
Susan Gibson, RN, Dallas, Texas
Howard Grossman, M.D., Polari Medical Group, New York
Esther Ross Hines and Jerome Hines, Kinston, North Carolina
Kevin Hinkle, New York, New York
Robert Kahn, Falls Church, Virginia
Cynthia Kaup, Clinton, Iowa
Philip Keiser MD, Texas
Mary Ann Kipuros, North Carolina
Abby Kovalsky, California
Patrick M. Lee - North Carolina
Melvin Littles, Yonkers, New York
Peter Locke, California
Winnie McCroy, managing editor, the New York Blade, New York
Michael L. McDuffie, North Carolina
Mitch McGee, Greensboro, North Carolina
Jim Musslewhite, Member, WA State ADAP Steering Committee, Washington,
Member, WA Governor's Advisory Council on HIV/AIDS
James M Nordlund, Stockton, Kansas
Sam Parker, LCSW, Greensboro, North Carolina
Leroy Patterson, New Jersey
Fran Pearson, MSW, Greensboro, North Carolina
Mark A.B. Peterson, Detroit, Michigan
Peter Pfeiffle, Denver, Colorado
Randy Phillps, Texas
James F Riley, Massachusetts
Marion J. Riggs. Tampa, Florida
Susan Rogers, New York, New York
Doug Rose, Member, New York ADAP Working Group, New York
Scott Roskilly, Texas
Javier G. Salazar, Hyattsville, MD
Rick Savastano, Florida
Ronald Seely, Granbury, Texas
Carmel Sexton, California
John G. Simms, Louisiana
Joseph Fisher Singleton, Texas
Naomi Skoglund, Brooklyn, New York
Debra Smith, Minneapolis, Minnesota
Joanne L. Smith, New Jersey
Jerry Spillman, ADAP client, Stanford University ACTG CAB member, Redwood City, California
Marian Spruill, Greensboro, North Carolina
Ronald P. Strauss, DMD, PhD, Chapel Hill, North Carolina
Tracy Swan, New York
Richard Everett Upton
Mabrey Russell Whigham, III, Mississippi
Keith Wayne, New York
Albert Whitaker, Massachusetts
Debra S. Wright, MSW, Michigan