Over 100 Patient Stakeholders Urge Secretary Price to Maintain Key Medicare Protection for Patients

The Partnership for Part D Access presented a letter today — cosigned by 111 individual patient advocacy organizations — to Department of Health and Human Services Secretary Tom Price, highlighting the importance to patients of the Medicare six protected classes policy. “The protected classes policy is essential for maintaining access to proper treatment for Medicare beneficiaries,” the letter states. “Patients with a condition in one of the protected classes have very complicated medical needs, and many of these patients must attempt a variety of therapies before coming to a decision with their physicians about what is the most appropriate treatment.”

---

In light of recent indications from the Office of Management and Budget (OMB) that a rule on the Part D program is expected in September, the Partnership — alongside its stakeholder allies from the patient community — sent the letter in order to deliver a strong and clear message to the Administration that the protected classes policy continues to provide essential access to medication for Medicare beneficiaries, enjoys widespread, bipartisan support, and should not be changed.

Individually, leading voices from across the patient advocacy spectrum further reinforced the importance of maintaining the six protected classes policy:

Chuck Ingolglia, Sr. Vice President of Public Policy and Practice Improvement at the National Council for Behavioral Health, pointed out that “for many mental health consumers, access to the full range of the most effective medications is a crucial component of successful treatment and recovery. Such medically necessary psychotropic medications, and their combination with other services and supports, are often essential to permit people with mental health and substance use conditions to recover and to lead healthy and productive lives in their communities. The six protected classes policy is crucial for guaranteeing access to these vital medications.”

Andrew Sperling, Director of Legislative Advocacy at the National Alliance on Mental Illness (NAMI), commented that “the six protected classes policy has proven time and again that it keeps patients healthy so they don’t have to turn to costly hospital stays for care. For those with mental health issues, Part D provides access to the life-saving medications that their doctors believe are most likely to help.”

The Depression and Bipolar Support Alliance’s Vice President of Advocacy, Phyllis Foxworth, said that “the six protected classes are vital so that those with mental health conditions like depression or bipolar disorder can choose their own paths to mental, emotional, and physical wellness. Any changes to this policy have the potential not only to undermine the hard-won advances a person with a mental health condition may have made, but also to undermine a person’s ability to choose the right treatment that a clinician identifies as the best fit for a serious, life-threatening condition.”

Jim Gleason, President of Transplant Recipients International Organization, noted that “patients and transplant physicians know that there is no one drug combination that works for every patient. Some patients may experience harmful side-effects from a particular drug combination that might work wonderfully for someone else. It takes a delicate balance to properly suppress the immune system in order to preserve an organ, while minimizing side-effects for each patient. The six protected classes ensure that patients get access to the treatment that works for them, and prevents a ‘one-size-fits-all’ approach to the way vital medications are prescribed.”

Angela Ostrom, Chief Legal Officer and Vice President Public Policy at the Epilepsy Foundation “strongly opposes any action that threatens the six protected classes in Medicare Part D. The six protected classes are a key safeguard for the vulnerable patients in our healthcare system. Restricting vulnerable patients’ access to necessary and appropriate medications is penny wise and pound foolish, and will lead to higher costs for the Medicare program.”

The AIDS Institute’s Deputy Executive Director, Carl Schmid, said that “Medicare Part D, including the six protected classes, is working. Beneficiaries, including those with HIV, are able to access the medications that their doctors prescribe. We encourage the Trump Administration to reinforce the six protected classes, and not implement policies that would diminish access to these critical medications.”