Plan to Limit Some Drugs in Medicare Is Criticized

[Yo_Mama]

14. And can there really be any medical rationale?

What we commonly see is that Medicare plans are too restrictive on these prescriptions already. I have people denied coverage for BP meds that are keeping them out of the hospital, because there is a generic - but the patient is either unresponsive to the generic or allergic to it.

I have had to send off pages and pages of documentation to justify a potassium sparing diuretic for a patient with heart failure just out of the hospital.

You are not going to lower medical costs if these patients can't get the medication they need, and for older people it actually gets much more difficult to balance med benefit/harms.

It's already so bad that the Medicare D cos don't want to pay for enough diabetic test strips so that we can really control blood sugars without severe hypoglycemia. When these patients get blood clots, strokes or heart attacks, the system pays an awful lot for treatment, but it doesn't want to fund $15 extra a month to prevent those incidents? Older people frequently don't have the money to pay for such necessities out of pocket.

I am sad to say that I have seen NOTHING good from Medicare attempts to control costs. Maybe the medical device programs are working better, but the other initiatives seem to be insane.