On Friday the American Cancer Society Cancer Action Network (ACS CAN) along with nearly 60 other patient advocacy organizations sent a letter to the Department of Health and Human Services (HHS) about how proposed changes to Medicare Part D’s six protected classes could hurt cancer patients’ timely access to drug therapies.
The six protected classes policy is designed to make sure Medicare beneficiaries are able to access innovative therapies by requiring Medicare Part D plan sponsors cover all or substantially all drug therapies in the designated six protected classes to treat cancer, epilepsy, HIV/AIDS, mental illness and organ transplants. HHS wants to alter rules to allow plan sponsors to use utilization management tools – including step therapy and prior authorization – to limit access to protected class drug therapies.
The letter explains the numerous ways in which this change could harm patients including restricting access to the most clinically appropriate treatments and increasing the possibility patients fail to fill prescriptions for or underutilizing their medications.