Medicare Cuts Are the Wrong Prescription
More than 1.5 million Americans are living with Rheumatoid Arthritis.
A diagnosis is life altering, as RA causes chronic swelling and pain and increases the risk of heart attack, stroke, and depression. After learning they have the disease, many patients head to their local Infusion Center for treatment, as many of the best medicines for RA are delivered via IV.
But if Medicare officials in Washington proceed with a new plan to cut Medicare funding, many of these centers will close or be forced to turn away patients who need these advanced treatments. This proposal, which impacts Medicare Part B, will deny patients convenient access to the medicines they depend on. It must be shelved.
Most patients with RA, cancer, osteoporosis, and other serious conditions rely on medicines that are delivered intravenously, under the supervision of a doctor. Today, clinics and Infusion Centers buy these medicines directly, and then Part B reimburses them the drug’s average sales price plus another 4.3 percent, which accounts for administrative costs, storage, overhead, and more.
Medicare officials plan to slash the reimbursement rate to the average sales price plus 0.9 percent and an additional flat fee of $16.80 per dose. That would drastically lower the reimbursement rate for advanced drugs while raising it for dated, less-expensive medicines.
For some patients, the change won’t matter – as the drugs they need have been on the market for decades. But for many patients, especially those with chronic, auto-immune diseases like RA, the best drugs are the newest, most-advanced medicines without cheaper alternatives.
Physicians will struggle to offer such drugs under Medicare’s proposal, so many will refer their patients to hospitals that can afford to carry the drugs.
Heading to a large hospital generally means longer travel and wait times. And because treatment costs are higher at hospitals, taxpayers will suffer, too.
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