This post originally appeared in Inside Health Policy on March 14, 2019.
A bipartisan group of more than 70 House lawmakers wants CMS to withdraw a proposal to weaken coverage protections in six classes of drugs, according to a March 13 letter to HHS Secretary Alex Azar. Patient and provider groups have been highly critical of the Trump administration’s proposal to let insurers use step therapy and prior authorization for drugs in those drug classes, and now CMS is feeling the pressure from Congress. The letter focuses on HIV drugs, which is the only class of drugs among the six that treats an infectious disease, but the lawmakers make clear they don’t want to weaken protections in any of the classes.
This post originally appeared in STAT News' "DC Diagnosis" Newsletter on Tuesday, March 19 2019.
HHS Secretary Alex Azar trudged up to Capitol Hill three separate times last week, and he got some tough but expected questions about Obamacare, the agency’s family separation policy, and myriad other hot-button health policy issues. But one line of questioning was striking — and surprisingly bipartisan: It concerned the agency’s idea of allowing private Medicare plans to not cover certain drugs that treat conditions like depression and HIV — drugs known as the so-called protected classes.
This post originally appeared in Targeted Oncology on March 15, 2019.
"The healthcare community is still awaiting a response from the Centers for Medicare & Medicaid Services (CMS) to the opposition of the agency’s proposal to substantially revise the Medicare Part D protected drug classes. Protection of the 6 drug classes within the Part D prescription drug plan, which include antineoplastics such as chemotherapies, was instituted in 2006 to ensure that commercial health plan sponsors of the newly launched Medicare Part D program would make these drugs available to patients."
This post originally appeared in The St. Louis American on March 14, 2019.
Recently, the Centers for Medicare and Medicaid Services (CMS) proposed a troubling regulation that would weaken Medicare Part D, the federal program that helps 45 million American seniors and people with disabilities afford prescription drugs. Part D is unique among government programs. The federal government allows people to purchase coverage from private insurers. The government subsidizes these plans but otherwise lets Medicare beneficiaries choose the coverage that's best for them.
Leading stakeholders within the HIV/AIDS community recently penned op-eds outlining the detrimental effects that the Trump administration's proposed drug pricing rule would have on patients. The authors astutely note that a "one-size-fits-all" approach is the wrong solution given the complexity of the disease as well as the individual needs of HIV patients. Stakeholders also emphasized that reliance on step therapy and prior authorization would create additional barriers to access for lifesaving treatments.
This post originally appeared in the Chagrin Valley Today on March 7, 2019.
The Trump administration is poised to undermine senior citizens’ access to lifesaving medications. It recently proposed a rule that would weaken patient protections within Medicare’s “Part D” prescription drug benefit. Part D drug plans are required to cover all drugs in six “protected classes” of medicines. This ensures that seniors have widespread access to drugs used to treat cancer, depression, HIV and more.The administration wants to allow insurers to stop covering some drugs in the six protected classes. This change could result in poorer health outcomes for Medicare’s most vulnerable beneficiaries – and inflate health spending in the longrun.
As reported today by Politico, a new proposal to weaken Medicare's six protected classes policy could harm national efforts to eradicate HIV — a top priority of the Trump administration and HHS Secretary Alex Azar. "That's according to Precision Health Economics, which argues that applying negotiation tactics for protected classes drugs in Medicare Part D could harm patient access and end up hurting efforts to eradicate HIV. It's the latest in an effort led by AIDS United and other disease advocacy group to keep Medicare requirements to cover all protected class drugs."
This post originally appeared in The Independent on March 8, 2019.
Recently, the Centers for Medicare and Medicaid Services proposed a troubling regulation that would weaken Medicare Part D, the federal program that helps 45 million American seniors and people with disabilities afford prescription drugs. Part D is unique among government programs. The federal government allows people to purchase coverage from private insurers. The government subsidizes these plans but otherwise lets Medicare beneficiaries choose the coverage that’s best for them. Congress did put some guardrails on insurers when it created Part D. It required Part D plans to cover all medications in six “protected classes” of drugs, including antipsychotics, antidepressants, and anticonvulsants. These medicines help treat people with schizophrenia and other psychiatric illnesses.
This post originally appeared in the Daily Memphian on February 27, 2019.
As we trudge through February’s chill, rain and the ever-present potholes, I can’t help but look forward to the start of baseball season and those summer days having a cold beer while cheering my favorite team. Baseball is unpredictable. A stolen base, a wild pitch or a ninth-inning home run can change the course of the game. Epilepsy, like baseball, is unpredictable. Heat, humidity and exposure to the sun can trigger a seizure, and that’s what happened to a friend of mine who accompanied me to a game last season. The unpredictable nature of the disorder often makes epilepsy difficult to control and manage.
This post originally appeared in The Virginia Gazette on February 19, 2019.
At his pre-election campaign rallies, President Trump promised to protect Medicare. But now, his administration quietly embraces drastic changes that could choke off seniors' access to lifesaving treatments. Consider the administration's new guidance for Medicare Advantage, which enables about 20 million Medicare beneficiaries to obtain subsidized health plans from private insurers. The guidance, which took effect in January, allows insurers to force beneficiaries to try older, low-cost medications before they can access more advanced, expensive drugs.