Important legislation that would prevent stripping antidepressants and immunosuppresants of their protected status

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Published on March 21, 2016

They are at it again. This time, however, there is a bill that would permanently protect the six classes of medications.

The Medicare Formulary Improvement Act (S.648), was introduced in March by Senator Charles Grassley (R-IA) and Senator Sherrod Brown (D-OH)

Last year, the Obama Administration proposed a regulation that sought to undermine a long-established pro-patient policy by stripping antidepressants and immunosuppresants of their protected status within Part D prescription drug plans. While that proposal was ultimately withdrawn, the Senate is now considering important legislation that would cement today’s protections by codifying the current provision under Medicare Part D that ensures open access to beneficiaries in need of potentially lifesaving antidepressants, immuno-suppressants, antipsychotics, anticonvulsants, oncology, and HIV/AIDS drugs.

This bill, the Medicare Formulary Improvement Act (S.648), was introduced in March by Senator Charles Grassley (R-IA) and Senator Sherrod Brown (D-OH). Unfortunately, this effort is currently stalled in the Senate pending a necessary “scoring” of the bill by the Congressional Budget Office (CBO). The bill’s sponsors do not believe that the bill will increase costs to the federal government, but without the CBO’s analysis, Congress simply won’t allow the bill to move forward.

While this may seem like a minor procedural hiccup, to patients dealing with mental health challenges, organ transplants, epilepsy, Parkinson’s Disease, lupus, cancer, or HIV, approval of this bill could mean the difference between life and death.

Every day, millions of Americans rely upon their Medicare prescription drug benefit to help manage their serious health conditions. For those classes of medications that treat the most serious conditions and diseases – antidepressants, immunosuppressants, antipsychotics, antiretrovirals, anticonvulsants and antineoplastics – extra protections were added. Because patients that rely on these medications may react differently to each treatment, access to the full range of effective medications is a crucial component of successful care. Medicare’s “Six Protected Classes” policy has long stood as a guarantee to patients that their access to all available medications would never be in doubt.

Contact your Senators and let them know how important it is to support here.

Unfortunately, changes to this policy that have been advanced by the Medicare agency (“CMS”) could deny patients access to these vital medications. While CMS recently withdrew this proposal after an outpouring of concerns were submitted by patient groups and Medicare beneficiaries, the agency went on to suggest that these protections could come under scrutiny again “in future years.”

In March of this year, Senators Charles Grassley (R-IA) and Sherrod Brown (D-OH) introduced the Medicare Formulary Improvement Act (S.648). Unfortunately, this effort is currently stalled in the Senate pending a necessary “scoring” of the bill’s budgetary impact by the Congressional Budget Office (CBO). The bill’s sponsors, and we, believe that the bill will score at a cost of “zero,” but without the CBO’s analysis, Congress simply won’t allow the bill to move forward.

We need you, and patient advocates across the country, to encourage their Senators to ask CBO to swiftly analyze the bill so that they can determine whether, and how, to move forward with this important initiative.

Here is a sample letter.
Thanks to Thorn Run Partners