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 Representative
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Medicare and Self-injected Therapies
The issue is whether or not self-injected therapies will be included in the Senate Medicare Bill. If they are not included, these therapies would not be covered for payment by Medicare, and Medicare patients would not have access to the treatments they need for their autoimmune diseases
AARDA supports inclusion of the self-injected therapies amendment (Section 448 of the Senate Medicare Bill) into the final Medicare package. This important provision would extend Medicare coverage to new innovative self-injected therapies to treat chronic, often debilitating autoimmune diseases such as rheumatoid arthritis, multiple sclerosis and deep vein thrombosis. It would provide Medicare patients with coverage for the two year period until the broader Medicare prescription drug benefit becomes effective in 2006. While Medicare currently covers drugs and biologics that are administered in a physicians office, it does not cover self-injected therapies. This is an outdated Medicare policy. Access to self-injected therapies is particularly important to rural patients who may be unable to travel long distances to obtain needed care. In this day and age of promising new drugs and innovative modes of administration, Medicare should not discriminate against more patient-friendly, self-injected therapies. The self-injected therapies amendment would bring the Medicare program more up-to-date with current medical science by extending Medicare coverage to self-injected therapies that are prescribed as a complete replacement for a drug or biological currently covered by Medicare. This is a small but important change that Congress should make now. Most importantly, it will give patients new access to new treatments that will greatly enhance their lives. The provisions of the Access to Innovation for Medicare Patients Act (S. 465/H.R. 980) have been incorporated into the Senate Medicare bill. Senator Kent Conrad (D-ND), along with Senator Gordon Smith (R-OR), introduced an amendment that would provide for two-year Medicare Part B coverage of self-injected biologics. The amendment provides two-year coverage in order to bridge the gap to implementation of a Medicare prescription drug benefit in 2006. The incorporation of this amendment into the Senate Medicare bill is a great tribute to the leadership of Senator Patty Murray (D-WA) in shepherding the Access to Innovation for Medicare Patients Act in the past two Congresses
What you can do: The House version of the Medicare bill contains a smaller demonstration project on self-injected biologics. As the Medicare legislation goes to conference, it is important for interested persons to work hard to keep the Conrad-Smith-Murray amendment in the final Medicare bill. You can do this by clicking on AARDAs Congress Connect button and letting your congressional representative know your support of the issue.
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