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Rebecca Farley

Director, Policy & Advocacy, National Council for Behavioral Health

Panelists Explain Importance of Mental Health Drug Access to Congress

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The Partnership for Part D Access, of which the National Council is a member, this week hosted House and Senate congressional staff briefings to share patient and health care provider experiences that demonstrate the importance of protecting beneficiary access to proper care under Medicare’s Six Protected Classes policy.

By ensuring that Medicare Part D beneficiaries have access to all or substantially all medications in the six classes – including antidepressants and antipsychotics – this policy has protected patients’ access to individually tailored, lifesaving treatments. Held before overflowing hearing room crowds, this week’s briefings featured a pair of patient advocates for the mental health and epilepsy communities, Trudy Lapin and Carlton Zeigler.

The National Council’s Chuck Ingoglia moderated the panel, which also featured National Council member Dr. Jeanie Tse, Associate Chief Medical Officer of the Institute for Community Living, Dr. Nicole Brandt, Senior Care Pharmacist and Professor at the University of Maryland, Dr. Ray Martins, Chief Medical Officer of Whitman-Walker Health, Dr. Matthew Cooper, Director of Kidney and Pancreas Transplantation, MedStar Georgetown, and Dr. Joanne Buzaglo of the Research and Training Institute of the Cancer Support Community.

“We are excited to have had this opportunity to hear from such compelling patients and leading health care practitioners about the importance of maintaining access to protected status drugs under Medicare Part D,” said Chuck Ingoglia, Senior Vice President of the National Council, which is spearheading the Partnership for Part D Access. “It is vital that lawmakers and their staff see firsthand the impact of this benefit on peoples’ lives.”

“Living with poorly controlled seizures since I was 17 has led to an invisible disability that made it hard to stay employed and to manage multiple chronic conditions, like diabetes, that are the consequence of weight gain due to side-effects of epilepsy treatments,” said Zeigler. “I rely on Medicare to maintain access to my lifesaving medications and reduce my risk for sudden unexpected death in epilepsy (SUDEP).”

“There is lots of trial and error in finding the right combination of medicine to treat an individual’s mood disorder,” said Trudy Lapin, the panel’s other patient advocate. “I’ve done all I can to ask for your approval of medication’s role in treating brain disorders. Now I ask you—Congressional staff, experts, and policymakers—to consider the consequences of blocked access to medication for patients like me.”

Since its inception, Medicare Part D has been effective at both improving health outcomes and lowering costs for patients. Despite the success of the program, in January, CMS published a proposed rule that would change the agency’s current protected classes policy. The proposed changes would have restricted patients’ access to antidepressants and immunosuppressants in 2015, and antipsychotics in 2016.

After widespread opposition from Congress, patients, providers, and other concerned citizens across the country, CMS announced earlier this year it would not pursue this regulatory change. However, the National Council remains concerned about possible future efforts to roll back patient protections in Medicare Part D and will continue working to educate Members of Congress and their staff about the deleterious effects this would have on vulnerable patients. Click here to join our efforts by sending your legislators a message in support of the Six Protected Classes.