Washington, D.C. - An exciting new pilot program designed to help seniors with chronic and rare diseases to self administer their prescription drugs was unveiled yesterday by Secretary of Health and Human Services Secretary Tommy Thompson.
U.S. Congressman Kevin Brady (R-The Woodlands), a long time advocate for making prescription drugs more accessible and affordable for all Americans welcomed the news.
“About one-half million Americans are fighting a chronic disease and spending thousands of dollars on life saving medicines. This pilot program makes these drugs more accessible and affordable. For seniors, this demonstration program gives them help today with their drug costs,” said Brady.
The pilot program, the first ever of its kind, will provide 50,000 seniors help with their costly prescription drug bills when they opt to self administer their prescription drugs instead of visiting a doctor’s office. Breakthroughs in medical science are leaving patients with more options when it comes to treating disease. Instead of chemotherapy – some cancers can be treated with oral medications.
Congress established the demonstration project in the Medicare Modernization Act to provide coverage, in advance of the implementation of the prescription drug benefit in 2006, for self administered drugs that can be prescribed as a replacement for therapies which are administered by a health care provider. The demonstration project will measure patient outcomes and effectiveness, including an evaluation of cost savings to the Medicare program attributable to reduced physician and hospital outpatient services.
To be eligible for the pilot program, a beneficiary must be enrolled in Medicare Part A and Part B, Medicare must be their primary payer, and the beneficiary may not have comprehensive drug coverage through other sources (such as TriCare, Medicaid, or an employer or union sponsored plan). A beneficiary must also have a signed certification from a doctor that he or she requires one of the drugs covered under the demonstration for the indicated disease. Qualified applicants for the pilot program will be selected randomly in a lottery. For more information, call 1800- MEDICARE.
Examples of savings for seniors with chronic diseases over a year include:
» Patients with Chronic Myelogenous Lymphoma (a cancer) using Gleevec could save nearly 90 percent or $40,654 annually. Gleevec has an estimated annual cost of $45,952, but patients in the demo would only pay $5,298.
» Patients with Multiple sclerosis could save 75 percent or $12,260 annually off medicines that cost an estimated $16,298 annually. They would pay only $4,038.
» Patients with rheumatoid arthritis could save 75 percent or $11,975 annually off medicines that cost an estimated $16,000. They would pay only $4,025.
» And patients with pulmonary hypertension using Tracleer could save 86 percent or $31,255 off of a cost that otherwise could reach $36,136. They would pay only $4,881.
