A nonprofit group has formed a partnership with three pharmaceutical companies and a mail order pharmacy to offer free antiretroviral (ARVs) drugs to people in states that have instituted waiting lists for their AIDS Drug Assistance Programs (ADAPs).

The great recession has hit people with HIV particularly hard. Lower tax revenues have decimated state budgets and have kept the federal government from offering enough dollars to meet the shortfall. As a result, programs like ADAP—which offer free HIV medications (and sometimes other drugs) through a combination of federal and state dollars—are suffering financial crises.

As of September 2010, nine states have frozen new ADAP enrollments and 3,214 people are on waiting list. Thirteen other states are considering new cost-containment measures. Though Congress approved a recent one-time infusion of additional cash, activists say it falls far short of what is needed.

The pharmaceutical industry does offer an alternative: The companies provide free medication through their patient assistance programs (PAPs) to people with low to moderate incomes who don't have health insurance. Activists have expressed concern, however, that some people who've been wait-listed for ADAP will fall through the cracks.

“The effort to obtain free drugs from programs run by the pharmaceutical manufacturers can be overwhelming, due to complicated paperwork processes, different income-eligibility determinations by each manufacturer, lack of a single entry point and other hurdles,” wrote Jeffrey R. Lewis—the president of the Heinz Family Philanthropies—in an opinion piece in the Boston Herald.

Lewis's foundation is working jointly with a mail-order pharmacy called Welvista and three ARV-producing pharmaceutical companies—Abbott, Merck and Tibotec—to offer free medications to people who've been put on ADAP waiting lists. What's unique about this partnership is that people don't even have to fill out any paperwork. It makes enrollment in the program automatic as soon as a person is placed on an ADAP waiting list. Free drugs are then shipped within a day to someone's home or to his or her provider's office.

“Unfortunately, Abbott, Merck and Tibotec are the only three pharmaceutical manufacturers that produce HIV/AIDS medications that currently participate in this program,” Lewis said. “The entry of all the other pharmaceutical manufacturers [notably Gilead, ViiV Healthcare, Bristol-Myers Squibb, Roche and Boehringer Ingelheim] would be greatly encouraged and welcomed.” These companies' participation will be necessary to help streamline access to ARVs not produced by Abbott, Merck and Tibotec.

HIV activist groups, such as the Fair Pricing Coalition, have urged these other companies to consider joining this partnership, and several are actively considering it.

“We are driven by a simple belief that the forces of the marketplace can drive the kind of instrumental change that government cannot or will not accomplish on its own,” Lewis concluded.