State Pharmaceutical Assistance Programs

10/26/2022

Pharmacists

Research suggests that increasing drug prices affects some patients’ ability to adhere to their medication regimen. To help with the affordability of prescription drugs, lawmakers have considered state pharmaceutical assistance programs, known as SPAPs.  

State Pharmaceutical Assistance Programs

SPAPs are state-run programs that provide financial assistance to certain populations to help pay for prescriptions, though coverage varies widely by state, usage and specificity. Some SPAPs provide wraparound coverage for Medicare Part D, meaning they help cover the cost of prescriptions that Medicare Part D does not pay for. Some SPAPs, such as Maine’s Low Cost Drugs for the Elderly and Disabled Program, assist a wider range of individuals; others, including AIDS Drug Assistance Programs (ADAPs), a type of SPAP that pays for HIV/AIDS-related prescriptions, target specific populations.  

Historically, SPAPs were funded only by states. However, this changed when the 2006 Medicare Modernization Act officially recognized SPAPs, providing them with extra funding and support from the federal government. The Centers for Medicare & Medicaid Services outlined requirements states must meet to operate as “qualified SPAPs,” which receive additional federal benefits, including support from CMS in organizing Medicare Part D plan options.  

SPAP eligibility requirements vary by state and program. Some programs cover those who are unable to qualify for Medicare, while others may provide coverage for medications for certain diseases, like the ADAPs mentioned above. ADAPs receive some funding from the Health Resources and Services Administration as well. The effect of SPAPs is noticeable, with a recent study showing overall savings provided for program participants.  

State Discount Programs

Many states have established a subcategory of assistance programs known as a state discount program, sometimes termed “prescription buying clubs” or “discount cards.” Like SPAPs, state discount programs typically have eligibility requirements. However, these efforts differ from SPAPs because they do not rely on subsidized state or federal funds to pay for the pharmaceuticals. Instead, some state programs use their individual purchasing power to buy large quantities of various medications. The consumer then pays the resulting discounted price at the pharmacy counter. States implementing or maintaining discount programs will often use pharmacy benefit managers to handle price negotiations.  

Eligibility requirements vary from by state. Arizona’s CoppeRx is available to all residents, for example, while California’s Prescription Drug Discount Program for Medicare Recipients is only available to those eligible for Medicare. The federal 340B Program is similar in that participating manufacturers give discounts to certain types of health care facilities. However, states oversee program administration.  

State Action

At least 48 states have an SPAP, with 13 states also providing state discount programs. 

State   

State Pharmaceutical Assistance Program (SPAP)  

Discount Rx Programs   

Alabama   

Alabama AIDS Drugs Assistance Program  

SenioRx   

N/A   

Alaska   

Senior Benefits Program   

Extended by AK HB 236   

N/A   

Arizona   

Arizona AIDS Drug Assistance Program   

Arizona CoppeRx Card   

Arkansas   

Arkansas Ryan White Part B/ADAP Program    

N/A   

California   

AIDS Drug Assistance Program   

California Drug Discount Program for Medicare Recipients   

Colorado   

Bridging the Gap Colorado; also Ryan White Part B and Colorado Bridging the Gap   

N/A   

Connecticut   

CT ADAP   

   

N/A   

Delaware   

Delaware Prescription Assistance Program  

Chronic Renal Disease Program (CRDP)   

N/A   

District of Columbia   

DC ADAP   

N/A   

Florida   

AIDS Drug Assistance Program    

Florida Discount Drug Card Program   

Georgia   

Georgia AIDS Drug Assistance Program    

N/A   

Hawaii   

N/A   

N/A   

Idaho   

Idaho ADAP   

N/A   

Illinois   

Illinois AIDS Drug Assistance Program   

N/A   

Indiana   

HoosierRx   

N/A   

Iowa   

Iowa Department of Public Health   

N/A   

Kansas   

Kansas ADAP   

N/A   

Kentucky   

Kentucky ADAP    

Kentucky Pharmacy Assistance Program (KPAP)    

Louisiana   

Louisiana Health Access Program  

Louisiana Department of Health’s STD/HIV/Hepatitis Program (SHHP)   

N/A   

Maine   

Maine Drugs for the Elderly and Disabled    

 

Maine Rx Plus   

Me. Stat. tit. 22 § 2681  

Maryland   

Maryland AIDS Drug Assistance Program  

Maryland Senior Drug Assistance Program   

Md. Code Regs. 10.09.60, et seq.   

N/A   

   

Massachusetts   

Prescription Advantage   

MGL c. 19A, § 39   

651 CMR 15.00   

N/A   

Michigan   

Michigan Drug Assistance Program (MIDAP)   

Michigan Prescription Savings Program (MiRx)   

Minnesota   

N/A  

N/A   

Mississippi   

MS ADAP   

N/A   

Missouri   

MoRx   

Mo. Rev. Stat. § 208.782   

N/A   

Montana   

State of Montana HIV Treatment Program  

Big Sky Rx Program   

Mont. Admin. R. 37.81.301   

N/A   

Nebraska   

N/A   

N/A   

Nevada   

Disability Rx Program  

SRx Program   

Nev. Rev. Stat. § 439.630   

Northwest Prescription Drug Consortium  

NV S 380 (2021)   

NV S 396 (2021)   

New Hampshire   

New Hampshire AIDS Drug Assistance Program (ADAP)   

N/A   

New Jersey   

NJ AIDS Drug Distribution Program (NJADDP)  

NK Pharmaceutical Assistance to the Aged & Disabled Program (PAAD)    

N.J. Admin. Code § 10.167.1.1  

NJ Senior Gold Discount Card Program   

N.J. Stat. §30:4D-45   

N/A   

New Mexico   

New Mexico Medical Insurance Pool (NMMIP)                

New Mexico Prescription Drug Assistance Program   

   

New York   

NYS Elderly Pharmaceutical Insurance Coverage (EPIC) Program   

N.Y. Elder Law § 240  

NYS Uninsured Care Programs   

N/A   

North Carolina   

North Carolina HIV Medication Assistance Program (HMAP)   

N/A   

North Dakota   

North Dakota AIDS Drug Assistance Program (ADAP)  

North Dakota Prescription Connection   

N/A   

Ohio   

Ohio HIV Drug Assistance Program (OHDAP)   

Ohio Golden Buckeye Program   

Phone: (866) 923-7879   

Ohio Rev. Code § 173.06   

Oklahoma   

Rx for Oklahoma Prescription Assistance   

N/A   

Oregon   

CAREAssist   

Oregon Prescription Drug Program (OPDP) (part of NW Prescription Drug Consortium)  

O.R.S. § 414.312   

Pennsylvania   

Chronic Renal Disease Program (CRDP)  

Pharmaceutical Assistance for the Elderly (PACE)  

PACE Needs Enhancement Tier (PACENET)  

Special Pharmaceutical Benefits Program/ADAP  

Special Pharmaceutical Benefits Program – Mental Health   

N/A   

Rhode Island   

Rhode Island State Pharmaceutical Assistance to the Elderly (RIPAE)   

R.I. Gen. Laws § 42.66.2.1-2   

N/A   

South Carolina   

South Carolina AIDS Drug Assistance Program (HIV+)   

N/A   

South Dakota   

South Dakota Department of Health Ryan White Part B Care Program   

N/A   

Tennessee   

Ryan White Part B Program for HIV Positive People   

CoverRx    

   

Texas   

Texas Kidney Health Care Program  

Texas HIV Medication Program    

N/A   

Utah   

Utah Ryan White Part B   

N/A   

Vermont   

VPharm   

33 V.S.A. § 2073   

Healthy Vermonters Discount Program    

Bill Summary    

Virginia   

Virginia Medication Assistance Program (VA MAP)   

N/A   

Washington   

Washington HIV Care   

Washington Prescription Drug Program (WPDP); part of NW Prescription Drug Consortium   

RCW § 70.14.060   

West Virginia   

West Virginia ADAP   

N/A   

Wisconsin   

SeniorCare   

W.I. Stat. § 49.688  

Wisconsin ADAP    

N/A    

Wyoming   

Wyoming ADAP  

Wyoming Prescription Assistance Program   

Wyo. Stat. § 42-4-118   

N/A   

*SPAP pages sourced from medicare.gov.