Until now, Part D required access to all medications within the “six protected classes” of drugs, which include antiretrovirals used by people with HIV and AIDS. This classification was created and subsequently enacted into law as part of the ACA due to patients’ needs and the fact that the minimum of only two drugs per class were insufficient. In the name of cost saving, the administration is proposing to limit the medications covered in three classes: immunosuppressants, antidepressants and antipsychotics.
This proposal has caught the attention of the Congress and was the subject of a House Energy and Commerce Health Subcommittee hearing on Feb. 26. While these days it is hard to find agreement between Republicans and Democrats, in this case, wide opposition to this proposal came from both sides of the aisle.
Sadly, the true cost will be the pain inflicted on patients due to a severe restriction in access to medications. In many cases, this will necessitate alterations to effective treatment plans. CMS fails to take into account that not all medications in each class are the same and providers prescribe medications that best meet the needs of their patients. Altering those treatments could have an adverse impact on patients with complex health needs. We are very worried that antiretrovirals could soon be the next class to lose protection.
The Obama administration has done much to improve the health and well-being of many Americans, including people with HIV and AIDS, but we believe they are not currently implementing the law that Congress passed and prioritizing the interests of patients as they should be. Therefore, we urge them to withdraw the proposal to change drug coverage in Medicare Part D that has enabled access to medications that best meet patient needs. Additionally, we remain committed to the successful implementation of the ACA but insist on enforcement of the anti-discrimination policies Congress included to protect vulnerable populations.
Carl Schmid is deputy executive director for The AIDS Institute.
Rep. Eric Swalwell, D-Calif., walks on Broadway after a Future Forum with young entrepreneurs in the Flatiron District of New York City, April 16, 2015. Reps. Steve Israel, D-N.Y., Seth Moulton, D-Mass., and Grace Meng, D-N.Y., also attended.