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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

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Medicare's Part D regulations on off-label use are inconsistent with the more expansive Part B regulations, which allow for consideration of evidence of effectiveness in peer-reviewed literature in addition to the FDA label and the compendia. Part B's prescription drug coverage includes certain injectable cancer drugs and immunosuppressive drugs.

"As HIV clinicians, we are asking for the ability to present published data during the exceptions process that would demonstrate compelling evidence that an individual patient would benefit from treatments that cannot be covered by Medicare Part D programs under the current rules," said Bruce Williams, MD, MPH, a member of the HIV Medicine Association. "Often the debilitating effects of HIV or its treatments are best treated with medications that may not have been approved specifically for people with HIV/AIDS or for a specific condition, despite strong evidentiary support for the use in the medical literature."

The sign-on letter specifically urges Congress to amend the Medicare statutes to make Part D coverage of off-label uses consistent with Part B, allowing for consideration of peer-reviewed literature in determining coverage.

Medical Access for Patients Rx (MAPRx), a coalition of patient, family caregiver and health professional organizations, is working with other allied groups to build support for a Congressional action on this issue.

MAPRx is a coalition of patient, family caregiver and health professional organizations committed to safeguarding the well-being of patients with chronic diseases and disabilities under Medicare Prescription Drug Coverage. MAPRx member organizations collaborate with national and state policymakers to ensure that beneficiaries have the access to the medication therapies they need and deserve.

http://www.maprx.info


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SOURCE MAPRx
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