No “DEATH PANELS” here…. just denial/limiting access to care


Coverage Issues Limiting MS Patients’ Rx Access

More than one in five people with multiple sclerosis (MS; 22%) experienced negative changes in their insurance coverage within the past year, and almost one in four patients taking disease-modifying therapy (DMT) relied either partially or completely on discounted or free drug programs (24.7%) for their medications, according to a new study from researchers at the University of Alabama at Birmingham (Neurology 2016 Jun 29. [Epub ahead of print]).

The researchers surveyed a total of 6,662 participants in a registry sponsored by the North American Research Committee on MS regarding health insurance coverage in 2014. Nearly all (98.5%) had health insurance coverage, but 6.1% of the respondents not currently taking DMTs cited insurance or financial concerns as their sole reason not to be taking those drugs. Of those on DMTs who obtained their drugs through insurance, 3.3% experienced initial insurance denial of DMT use, 2.3% encountered insurance denial of DMT switches, and 1.6% skipped or split doses because of increased copay requirements. For respondents with relapsing-remitting MS, negative insurance change increased their odds of not taking DMTs (odds ratio [OR], 1.50; 95% CI, 1.16-1.93), using free/discounted drug programs for DMTs (OR, 1.89; 95% CI, 1.40-2.57) and encountering insurance challenges (OR, 2.48; 95% CI, 1.64-3.76).

The findings were not surprising to Fred D. Lublin, MD, the director of the Corinne Goldsmith Dickinson Center for Multiple Sclerosis at the Icahn School of Medicine at Mount Sinai, in New York City, but he lamented the situation. “It is unfortunate that insurance coverage plays any role in the ability of individuals to obtain the medication that they and their provider determine to be the best choice for them,” he said.

The study is also consistent with what the National Multiple Sclerosis Society is hearing from the MS community, according to Kimberly Calder, the society’s director of health policy. “We are extremely concerned about the price of MS therapies and their impact on access to care for people with MS. The society has recently formed an Advisory Committee on Access to MS Medications to better understand all the complex factors contributing to the escalating costs of the MS disease-modifying medications and the increasing challenges people with MS are facing in accessing their medications. The committee is charged with developing recommendations for the society’s further action on these issues.”

One Response

  1. I believe there are ,”death panels,”,,,I saw on another site bout 4 years ago,,thee average 1st time bill for people from a hospital,,it was 6 to 10 grand,,,,all of a sudden ALLL our deductible and out of [pockets went to 6 to 10,000 grand,,,soo yes,,i believe there are some sicko’s behind the curtain paid for by my hubby’s tax dollars telling obamacar who will die,soo no need to treat them anymore,,,1000 %%% I believe there is a ,”death panel,”,,maryw

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