In a letter to Congress, the Chronic Care Policy Alliance (CCPA) expressed its opposition to a proposed policy change to Medicare Part D. Read the full letter:
For millions of seniors and patients living with disabilities, a robust Medicare Part D program is a significant and irreplaceable component of successfully maintaining their health, well-being, and quality of life. Today, Medicare Part D provides consistent and affordable access to medications for a population of Americans disproportionately affected by chronic conditions. These medications are a vital part of managing their conditions and maintaining their health.
Part of what makes Part D as we know it today such a transformative program for America’s seniors and people with disabilities is the broad and comprehensive availability of medications within the plan design. Provisions put in place when the Part D program was created ensure that most classes of medications have at least two drugs available to beneficiaries and classes of medications that treat the most complex conditions cover almost all drugs in the class.
Broadly speaking, this extensive coverage, option for competitive plan selection and absence of a restrictive national formulary make Medicare Part D plans some of the most patient and doctor friendly prescription drug coverage options in the American healthcare system. Doctors can tailor treatment plans to their individual patients and patients have access to those medications without fear that they won’t be available due to bureaucratic rules and restrictions.
As healthcare costs continue to rise across all facets of the healthcare system in the United States, policymakers are considering reforms to bring down costs. We share this laudable goal, as high costs can prove an insurmountable burden for patients seeking care. However, we urge policymakers to ensure that these reforms do not impede upon the ability of patients to access the range of medications they need and treatments on which they rely.
Unfortunately, one reform under consideration would do just that. Congress is considering repealing what is known as the non-interference clause in Medicare Part D, due to a misconception that this action would result in government officials being able to negotiate better prices for medications within Medicare without harming access for patients. However, the only way that the government would be able to negotiate significant costs savings would be by implementing access restrictions and restrictive medicine lists such as formularies. This would result in significantly limiting the medications available to patients in Medicare Part D.
In fact, the nonpartisan Congressional Budget Office has concluded repeatedly over the past 15 years that the negotiations that already take place between manufacturers and Medicare Part D plans already achieve significant discounts on drug prices. As stated above, CBO has found that the government would not be able to achieve additional discounts unless they also implemented a formulary for medication coverage under Medicare.
Cutting off access to medications by implementing a national formulary would likely have the opposite of its intended effect and ultimately lead to higher healthcare costs in the Medicare program. Research demonstrates that medication adherence reduces health costs and improves health outcomes. Creating new and unnecessary barriers to accessing needed medications by allowing the government to interfere in the Part D program could result patients no longer being able to access the medication that works best for them because the federal government would decide which medications would be on the formulary. Allowing providers to decide the best course of treatment for a patient is of the utmost importance.
Allowing the federal government to repeal the protections currently in place and create a national formulary would ultimately hurt the very patients that Congress is trying to protect by limiting their access to medications they need. A national formulary would reverse the comprehensive coverage on which millions of seniors and individuals with disabilities rely upon to address their complex health needs.
Lowering costs for government should not come at the expense of inferior care and worsened health for some of the most vulnerable among us. We urge you to reject calls to repeal the non-interference clause in Medicare Part D and instead focus on reforms that will protect patients and improve their access to care, like creating an out-of-pocket cap, protecting seniors and people with disabilities by spreading their costs over time and lowering coinsurance.
Allergy & Asthma Network
Allies for Independence
American Behcet’s Disease Association (ABDA)
Applied Pharmacy Solutions
Arizona Chronic Care Together
California Access Coalition
Caregiver Action Network
Cascade AIDS Project
Chronic Care Policy Alliance
Coalition of Wisconsin Aging and Health Groups
Emphysema Foundation of America
Healthcare Leadership Council
HIV + Hepatitis Policy Institute
International Foundation for Autoimmune & Autoinflammatory Arthritis (AiArthritis)
Life Sciences Pennsylvania
Looms for Lupus
Men’s Health Network
National Puerto Rican Chamber of Commerce
Neuropathy Action Foundation
Nevada Chronic Care Collaborative
New Jersey Mayors Committee on Life Sciences
New Mexico Biotechnology & Biomedical Association (NMBio)
New State Sickle Cell Advocacy Network. Inc. NY Chapter of SCDAA
New York Memory Center
North Carolina AIDS Action Network
Rare Access Action Project (RAAP)
Why We Vaccinate
ZERO Prostate Cancer