State of Arkansas
Arkansas AIDS Drug Assistance Program
Sponsor Organization
Arkansas
Prescription Medication Assistance Organization Contact
Division of AIDS/STD
Arkansas Dept of Health
4815 West Markham, Slot #33
Little Rock, AR 72205-3867
Phone: (800) 342-2437
Medications sent to: Patient’s Doctor
Prescription Medications/Products Covered:
3TC
Agenerase
AZT
Bactrim
Biaxin Filmtab
Biaxin Granules
Biaxin XL Filmtab
Cipro
Cleocin
Combivir
Crixivan
Cytovene
d4T
Daraprim
ddC
ddI
DDS
Diflucan
Emtriva
Epivir
Famvir
Fortovase
Fuzeon
HIVID
Humatin
Invirase
Kaletra
Kaletra Oral Solution
Lamprene
Lexiva
Mepron
Myambutol
Mycelex
Mycobutin
Mycostatin
Mykinac
NebuPent
Nilstat
Nizoral
Norvir Oral Solution
Norvir Soft Gelatin Capsules
Nystex
O-V Statin
Pentam
Pravachol
Rescriptor
Retrovir
Reyataz
Sporanox
Sustiva
Trizivir
Valcyte
Viracept
Viramune
Viread
Zerit
Ziagen
Zithromax
Zovirax
Program Eligibility Requirements:
Iincome must be at or below 300% of the current Federal Poverty Level, excluding Medical Expenses
Clients who are chronically infected (duration of infection presumed to be > 6 months based on exposure history, clinical findings, CD4 count) with HIV, who are ineligible for Medicaid, must meet at least one of the following criteria:
- Symptomatic AIDS or,
- Baseline (pre-treatment) CD4+ T-cell count < 350/mm3 or,
- Baseline (pre-treatment) HIV viral load > 55,000 (RT-PCR) or >30,000 (bDNA)
Pregnant HIV-infected women are eligible regardless of CD4 count and viral load.
Clients who are acutely infected (duration of infection presumed to be < 6 months based on exposure history, clinical findings, CD4 count) regardless of CD4 count and viral load.
When situations occur where the clinician believes that antiretroviral therapy is indicated for a client who does not meet any of the above criteria. The Medical Director of the HIV/STD/TB Team will review the case and determine the appropriateness of eligibility.
In the event that clients have to be triaged because they have just been released from the hospital, prison, or are moving into the state, every effort will be made to provide medications; particularly for those who are very ill and who, in the mind of the clinician, would die soon without medication support. These situations will be monitored and a determination made on a case-by-case basis. Clinicians may request emergency triage status for clients meeting the following criteria:
- CD4 <200 and
- Recent occurrence (within the preceding 2 months) of a major opportunistic infection or malignancy (category C in the CDC classification).
- Drugs provided in an emergency situation will be supplied for a maximum of 60 days, allowing time for Application Form to Medicaid, Patient Assistance Program (PAP)s, or ADAP.
Additional Information and/or Requirements (known):
Call ADAP Pharmacy at (877) 288-8506 for the nearest location.
Link: Prescription Medication Program Website
