"Inside Health Policy: More Than 100 Patient Groups Warn Against Eliminating Protected Drug Classes In Part D"

September 12, 2017

Inside Health Policy: More Than 100 Patient Groups Warn Against Eliminating Protected Drug Classes In Part D

A new article in Inside Health Policy highlights a letter from the Partnership for Part D Access and 112 other patient organizations to HHS Secretary Tom Price warning the agency against making changes to Medicare’s ‘six protected classes’ policy. “More than 100 patient-advocate groups are warning against eliminating coverage protections for drugs in six therapeutic classes in an upcoming Part D proposed rule,” the letter states. “The contents of the proposal are unknown, but lobbyists for industry and patients are on edge because CMS plans to propose the first Part D rule since it pursued aggressive policy changes three years ago, according to the regulatory agenda... ‘These tools give Part D plans considerable flexibility to manage more expensive medications, as well as leverage to negotiate rebates with manufacturers,’ the Partnership for Part D Access wrote in a Sept. 8 letter to HHS Secretary Tom Price. Limiting access to drugs in protected classes would probably lower drug spending, but it would do so at the expense of higher hospital costs, the group says.”

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

September 11, 2017

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.”

"Study: ‘Profit-Maximizing’ Part D Plans Cause Increases in Overall Medicare Spending"

May 09, 2017

Study: ‘Profit-Maximizing’ Part D Plans Cause Increases in Overall Medicare Spending

A new study by economists Amanda Starc of Northwestern’s Kellogg School of Management and Robert Town of the University of Texas highlights how “profit-maximizing” Part D plans are incentivized to limit benefits or increase costs for Medicare beneficiaries because they are not responsible for costs incurred by other parts of the Medicare (ex. hospitalizations). As detailed in the study, Part D plans are motivated by incentives that are sometimes counter to the best interests of patients; they are explicitly incentivized to reduce drug spending, while they have no financial responsibility for the holistic health of the patient. In the study, the authors conclude that in covering drugs less generously, Part D plans end up costing traditional Medicare $475 million per year – a stat that does not account for other social costs, such as the inconvenience and suffering of beneficiaries who end up in the hospital.  This study highlights the importance of Medicare’s six protected classes, which ensure that patients with the most complex conditions are guaranteed access to the full range of drugs under Medicare Part D – limiting future medical complications, hospitalizations, and additional costs to the Medicare program. 

"Vox: Treating Depression is Guesswork"

April 25, 2017

Vox: Treating Depression is Guesswork

A recent article in Vox examines the challenges in diagnosing proper treatments for people with depression, namely the fact that not all treatments work for every patient. The author hones in on the frustrations depression patients face when they are prescribed medicine or therapy that is designed to help treat depression, but are ineffective to their specific needs, and show varying results from patient to patient due to the complexity of the disease itself. “No one thinks those two people have the same biological problem,” said Conor Liston, a research psychiatrist at Weill Cornell Medical College. “And yet those two people get the same label.” This article underscores the importance of the six protected classes, as proposals to limit access to certain medications under the Part D program which are not interchangable - such as antidepressants - would have a profound impact on the patients who benefit from having access to the full spectrum of treatment options.

"NIH Warns Against Use of 'One-Size-Fits-All' Treatments for Depression"

November 01, 2016

NIH Warns Against Use of 'One-Size-Fits-All' Treatments for Depression

The National Institutes of Health (NIH) recently published an article that highlights the necessity of unique treatment approaches for individuals battling depression. Depression, one of the most common mental disorders in the U.S., is not easily treated with  “one-size-fits-all” therapy, the article explains, and is usually treated using antidepressant medications, therapy, or a combination. "It’s often a trial-and-error process to figure out which approaches will work best for each individual," the author notes.  Researchers used information about early-life stressors and amygdala activity to predict the ability of certain antidepressants to treat symptoms of depression. Some correlation between physical differences in the amygdala and responsiveness to specific antidepressants emphasize the necessity of access to a range of antidepressants as part of individualized treatments. 

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