Access to Multiple Sclerosis Medications
- Sunday, August 9, 2009, 10:14
- Multiple Sclerosis
- 284 views
- Add a comment
- Dick:
- We have a question from David who is on the telephone with us from California.
- David:
- I’ve been on Social Security disability for six or seven years, therefore qualifying for Medicare. I’ve been on Avonex for about two-and-a-half years; self-injecting very successfully without one single problem. Now that Medicare is covering it, I’m posed with the problem of having access to it. For the last several years, through the goodness of Avonex and Biogen, they’ve been assisting me financially with this. And now they’re no longer able to because they say I’m now covered by insurance. My problem is none of the doctors around here are willing to partake of this.
- Dick:
- So you have to go to a clinic now?
- David:
- There is no place to go. I live in the country. They’ve been FedExing the Avonex to me in three-month quantities, and I’ve been going along just fine. But now I’ve called the local doctors, and nobody does injecting in their office and they don’t want to get involved with Medicare, and there are a thousand reasons why they don’t want to do it.
- Dick:
- Dr. Frohman, what does a patient like David do?
- Dr. Frohman:
- I think David is expressing some views that are shared by many patients who not only have been on the assistance program, but who may qualify for both Medicare but also have other insurance coverage, and now it’s sort of being deemed subordinated to Medicare. And they say, “Well, you have Medicare, you’re going to go ahead and go to your physician’s office,” and that can be a huge problem, and a number of these patients have been injecting just fine. I would suggest you contact the local chapter of the National Multiple Sclerosis Society. This is a very important point. Find out from their preferred provider list who are the physicians in your area that are seeing the majority of multiple sclerosis patients. I would bet there are a number of other patients in your area or in your region who are faced with a similar dilemma. If you ask the local chapter of the society to make contact with these physicians, it may be possible for you to receive these injections from a physician that is participating in that program.
- David:
- Been there, done that. Negative.
- Dr. Frohman:
- If you don’t have coverage and you can’t get to a physician’s office and there is no other way, then to be honest with you, even though we want to maintain patients on coverage and you can’t come out-of-pocket for the cost, you need to sit down and have a face-to-face with your physician and say, “What are my other treatment options?” If you’re economically in a situation where you are eligible for an assistance program with Biogen, it’s certainly possible that you would be eligible for an assistance program with the other companies. If you’re faced with a dilemma that you can’t get the drug any which way, then you’re going to have to say, “What are the other treatment options?” And sometimes I believe that that does justify a transition to a different agent.
I basically work for patients, so I have to find ways of creatively moving those patients to a situation where they get treatment somehow, some way. I know that’s difficult, particularly if you’ve done well on a drug for a period of time. You’ve been on this drug for two-and-a-half years, and there is real a reluctance to adjust therapy. But the reality is if you can’t find a participating clinic, you don’t have the resources to cover this yourself, then I think you may have to look elsewhere in terms of altering your therapy.
A number of our folks here in Texas who come to see me from a far distance have been able to convince their local primary care physicians, their family practitioners and internal medicine specialists. They generally have a few patients in their practices that may have multiple sclerosis, and oftentimes they are willing to step up to the plate and facilitate this kind of program for two or three or five patients.
I think some of the reluctance on the part of neurologists in practice is they may be confronted with much larger numbers of patients, and a number of them are trying to determine how they’re going to participate in this program if they may have a large number of eligible patients that are coming to their clinic for a weekly injection.
We had to obviously deal with this ourselves here in Dallas before we decided to participate in the program. We think it’s very important for patients to have access to this kind of service. But if you’re really far out there and you have access to some family practitioners and internists, they may be willing to do it for you. I can tell you that a number of physicians here in the state of Texas do exactly that for MS patients.
About the Author
admin has written 208 stories on this site.
Write a Comment
Gravatars are small images that can show your personality. You can get your gravatar for free today!