Skip to comments.Plan to Limit Some Drugs in Medicare Is Criticized
Posted on 02/24/2014 8:28:11 PM PST by Seizethecarp
An alliance of drug companies and patient advocates, joined by Democrats and Republicans in Congress, is fiercely opposing an Obama administration proposal that would allow insurers to limit Medicare coverage for certain classes of drugs, including those used to treat depression and schizophrenia.
The administrations proposal would remove the protected status from three classes of drugs that has been in place since the programs inception in 2006: immunosuppressant drugs used in transplant patients, antidepressants and antipsychotic medicines. They include many well-known drugs, such as Wellbutrin, Paxil and Prozac to treat depression, and Abilify and Seroquel to treat schizophrenia. Three other categories cancer, H.I.V. and anti-seizure drugs would retain their status as protected classes and insurance companies would be required to continue covering nearly all drugs in those treatment areas. Medicare has traditionally required the broad coverage because patients with these conditions must often try several drugs before finding one that works.
In proposing the change last month, the administration said that the policy was envisioned as a temporary measure to help ease patients transition to the new Medicare drug program, and that since then, insurers had lost their leverage in negotiating with drug companies because the drug companies knew the insurers were required to cover their drug costs and were therefore less willing to offer lower prices.
(Excerpt) Read more at nytimes.com ...
This is CONDITION RED for my family as one of the antipsychotics on this list returned a member to sanity from a deeply psychotic condition in the past few months. Numerous other antipsychotics (whether cheap or expensive) had failed.
I am so sorry to hear how this is impacting you and yours. This is exactly the problem with having the government deciding what a doctor should be deciding.
All of those who claimed they would repeal Ocare and haven’t offered legislation should be turned out on their ears
Some insurance protocols will cover the rarer drugs if more common ones are unsuccessfully tested first. But then the protocols are often wooden. Even if the patient has tested the unsuccessful drugs in the past, they have to be tested again, once on a particular policy.
As long as HIV drugs remain on the protected list, who cares about the others?
Gays dangerous sex practices must be protected and them too...it’s all about LOVE.
And so it begins for the Medicare crowd. (Me)
Wait until they decide that dialysis is costing too much
Is this Obama and the Democrats meddling in decisions between you and your doctor?
Schizophrenia drugs costing $4,500 per year save more than $70,000 in annual institutional treatment costs.
Generic Prozac costs $4 at Wal-Mart, but it’s one of the drugs Obama wants to eliminate.
Oh so this is how they start the implementation of the death panels.
The patient commits suicide.
“Is this Obama and the Democrats meddling in decisions between you and your doctor?”
This is the worst possible meddling!
In psychiatry each patient is a unique experimental research subject about whom nothing can be predicted regarding medication response.
The problem is that in my observation the transition from one med to another can be VERY dangerous and painful for the patient and family.
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“Oh so this is how they start the implementation of the death panels. The patient commits suicide.”
Sounds about right, sadly. My wife is a retired RN and I am a retired CPA and we can barely keep up with the medical issues and paperwork involved with Medicare in the family. I don’t know how the average family can survive the complexity. Those vulnerable to depression will have their risk of suicide increased, I expect.
“Schizophrenia drugs costing $4,500 per year save more than $70,000 in annual institutional treatment costs.”
“Generic Prozac costs $4 at Wal-Mart, but its one of the drugs Obama wants to eliminate.”
Often it is only the time-release formula that is effective and the generic is frequently not yet available, as is the case with Seroquel XR.
If you’re referring to one of Abilify and Seroquel, both can be procured from pharmaceutical manufacturers overseas, in generic equivalents (around $1 a dose). But you probably won’t have to.
Many of the generic drugs made by Sun and Intas are made only in the XR form, although they don’t have XR in the name. I don’t know about the two above, but it is the case with Effexor which I take.
And so it begins. We useless eaters are to be slowly eased out of existence by a thousand such cuts.
The non time release Seroquel is $16 for 60 tablets of quetiapine 25mg (generic) at Walmart with the type of coupon I use (GoodRx). Very unusual for more frequent administration of the non-XR to not “work”.