As people with chronic conditions age, it becomes increasingly important for Medicare programs to cover treatment and medication prescribed by their doctor. However, insurers continue to implement step therapy and prior authorization requirements in addition to putting drugs in different formularies to cut costs. These disruptions in care pose dangerous consequences to a patient’s health.
Let MI Doctors Decide, a coalition of patient organizations dedicated to fighting step therapy practices in Michigan, took a deeper look at Michigan’s Medicare program. Using methodology from recent research at Emory University, the coalition “graded” the 25 largest Medicare plans on their access restrictions for patients with the following autoimmune conditions: multiple sclerosis, psoriasis, psoriatic arthritis, rheumatoid arthritis and Crohn’s disease.
The report found that an overwhelming majority of the Medicare plans are failing when it comes to patient access to treatment across the five disease areas. In fact, only one plan received a passing grade for access to Crohn’s and multiple sclerosis therapies. Moreover, the results indicate a disturbing difference in access between public and private coverage, the latter of which received a passing grade in a separate report.
What does this mean for patients? President and Executive Director of the American Autoimmune Related Diseases Association Virginia Ladd commented on this in a recent release: “Senior citizens are already some of the most vulnerable patients in our health care system, and those with autoimmune diseases face even greater challenges to maintaining their health and quality of life. The last thing these patients need is the extra burden of insurance company practices like step therapy, which restricts access to necessary medicines for the sake of perceived short-term cost savings for the companies.”
The Chronic Disease Coalition believes that patients deserve access to quality, affordable health coverage. If Michigan is any indication, insurance companies aren’t performing in the best of interest of patients. Has your insurer failed you? Join us as we fight to increase health care accessibility for all chronic disease patients.
