WASHINGTON - The politically, medically and scientifically sophisticated response of the AIDS community to the HIV epidemic has pushed government to respond in ways that have permanently altered many aspects of the regulatory and health care delivery systems, from the FDA approval process to public involvement in clinical trial design to reimbursement for drugs. It also has forced the private sector to rethink the way it interacts with patients and government entities.

One manifestation of these changes is the AIDS Drug Assistance Program (ADAP), formally Title II of the Ryan White Act. The program provides federal funds to states to pay for AIDS drugs for uninsured and under-insured patients.

Another is the role pharmaceutical and biotech companies are playing in supporting lobbying efforts associated with ADAP.

Agouron Pharmaceuticals Inc., Chiron Diagnostics, Gilead Sciences Inc. and Triangle Pharmaceuticals Inc. have joined 11 pharmaceutical companies in a coalition with AIDS activist groups and state health officials - the ADAP Future Funding Working Group - to persuade Congress and the White House to increase spending on ADAP. The coalition has been the driving force behind the White House's provisional decision to urge Congress to increase its fiscal 1997 appropriation for the drug purchasing program from $23 million to $65 million.

ADAP co-chair William Arnold told BioCentury that the group is marshalling data to support the request. Pharmaceutical and biotech companies are playing a crucial role in developing those data, he said.