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Lack of Medicare Part D Coverage for All Medically Necessary Prescriptions Endangers Older Americans and Those with Chronic Diseases and Disabilities
Date:11/20/2007

Coalition of Patient and Consumer Groups calls for Legislative Action to

Ensure Access to 'Off-Label' Drug Treatments

WASHINGTON, Nov. 20 /PRNewswire-USNewswire/ -- Twenty-six patient, family caregiver and health professional organizations are calling upon Congress to pass legislation to require Medicare prescription drug plans to provide access to all medically accepted uses for the drugs they cover.

Medicare regulations exclude Part D coverage of a medication if it is prescribed for a use that is not on the Food and Drug Administration (FDA) label or supported by a citation in one of three specific medical compendia. In a sign-on letter to the Senate, the organizations wrote that the "exclusive reliance on FDA indications and a limited number of compendia prevents access to medically necessary, life-sustaining prescriptions."

Over 20 percent of the 500 most commonly prescribed drugs are used for off-label treatments. According to the letter, "People with cancer, HIV/AIDS, lupus, multiple sclerosis, debilitating pain, and mental health conditions, and other rare and serious conditions are routinely prescribed drugs off-label to manage disease symptoms and progression." The letter is available at http://www.medicarerights.org/maprxlettertobaucus.pdf

"We know of a number of people who have been hospitalized or been required to take other more expensive treatments because they did not have access to their prescribed medicines," said Andrew Sperling, Director of Legislative Advocacy, National Alliance on Mental Illness.

For specific cases and more information, see the Medicare Rights Center's report, "Off-Base: The Exclusion of Off-Label Prescriptions from Medicare Part D Coverage," available at http://www.medicarerights.org/Off-label_PartD_Coverage.pdf<
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SOURCE MAPRx
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