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Christine Farrell: Change to Part D program would jeopardize seniors’ health

A Yale researcher just concluded that the Food and Drug Administration reviews and approves new medicines faster than its peer agency in Europe. Unfortunately, Connecticut seniors may never benefit from these breakthrough drugs.

That’s because Congress is poised to change the structure of Medicare’s prescription drug benefit program, or Part D. The alterations would compromise seniors’ access to life-saving medicines and their relationship with their doctors. 

Medicare Part D took effect more than ten years ago. The program provides affordable prescription drug coverage to more than 40 million American seniors and people with disabilities. More than 330,000 Connecticut residents are enrolled. 

Part D has surpassed the federal government’s highest expectations. It provides beneficiaries with affordable medicines — and it does so under budget. Part D cost $349 billion less than initial projections in its first decade. 

Part D’s biggest strength is that it lets seniors pick the insurance plans that best fit their budgets and needs. Connecticut residents can choose from among 21 different Part D plans, including ones with no deductibles and premiums as low as about $15 per month. The plans are transparent, so patients can check beforehand to see which drugs are covered and at what rates.

As a result, Part D strengthens the doctor-patient relationship. Doctors can prescribe seniors pretty much any drug — and seniors can find a Part D plan that covers it at an affordable rate.

In this way, Part D has measurably improved the lives of our senior citizens. When seniors are able to afford the medicines their doctors prescribe, they avoid preventable diseases, complications, emergency room visits, surgeries and hospital stays. In fact, Part D coverage is linked to an 8 percent decrease in senior hospitalizations. 

But if Congress tampers with Part D, it would jeopardize these gains. Specifically, lawmakers want to repeal Part D’s non-interference provision.

The provision bars government bureaucrats from getting involved in price negotiations between drug manufacturers and the insurers who design and administer Part D plans. These private insurers negotiate drug discounts and rebates with drug makers. Insurers pass these savings along to consumers in the form of minimal copays, low premiums, and more.

Insurers won’t attract customers if they don’t offer competitively priced plans. And they can’t offer affordable plans if they don’t secure discounts on drugs. So they haggle hard. 

Many lawmakers claim the government would be a tougher negotiator than private insurers, and thus secure bigger discounts for seniors. In fact, the nonpartisan Congressional Budget Office has found that repealing the non-interference clause alone is unlikely to yield significant savings.

The only way the government could secure lower prices is if it establishes a single list of approved medicines and leaves certain prescription drugs off of it. But that decision would cut many patients off from the medications their doctors prescribed.

Patients covered by the Department of Veterans Affairs know this struggle all too well. The VA’s single list of approved drugs covers far fewer medicines than does Part D. In fact, the VA excludes nearly 1 in 5 of the top 200 most commonly prescribed Part D drugs. Among those excluded are medicines that treat asthma, type 2 diabetes, and osteoporosis — exactly the diseases for which Connecticut’s seniors need treatment.

So what do VA patients do when their doctor prescribes a medicine that’s not covered? They either forgo the medicines their doctors prescribed, pay for their medications out of pocket or buy additional prescription-drug coverage elsewhere. In fact, up to 40 percent of eligible veterans access prescription medicines through Medicare Part D. 

Quick FDA approvals for new medicines only help patients if their insurance plans cover those drugs. If Congress interferes with Medicare Part D and lets federal officials dictate which medicines should be covered, seniors would likely lose access to advanced, life-saving treatments.

Christine Farrell is a board member for the Services for the Elderly, a nonprofit in Farmington. 

Article source: http://www.norwichbulletin.com/opinion/20170525/christine-farrell-change-to-part-d-program-would-jeopardize-seniors-health

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