ADVOCACY ALERT!
Tell us about it: Changes to your prescription coverage
People with MS should be aware that some health insurance companies are changing prescription coverage for the disease-modifying drugs. These changes, often called cost management strategies, include placing the ABCR drugs on a non-formulary list or assigning them to a lower tier of coverage. As a result, clients may experience significantly increased co-pays for their medication.
The Chapter’s Clinical Advisory Committee (CAC), chaired by David Mattson, MD, PhD, opposes these changes and is working to keep all medically-necessary and FDA-approved MS immunotherapies available to those with MS.
Essential to the CAC’s progress is collecting data that will help them to identify, define, quantify, and track this problem as it evolves. This is how those with MS can help:
1. Read all correspondence from your health insurance company.
2. If a change in prescription coverage is implied or stated, contact your insurer for details about new drug co-pays and/or out-of-pocket limits.
3. Request all information in writing, and keep good notes of your calls.
4. Provide the CAC with this documentation. Supply only what you feel comfortable sharing. All identifying information (name, address, phone, etc.) will be considered confidential.
Any information can be sent to Heather Donegan, Director of Chapter Programs.
Fax: 317-870-2520. Or email heather.donegan@nmss.org.
Mail: 3500 DePauw Boulevard, Suite 1040, Indianapolis, IN 46268.
For those with an adverse change in prescription coverage that results in unaffordable co-pays, help may be available from your pharmaceutical company’s patient program: Avonex Alliance; MS Pathways (Betaseron); Shared Solutions (Copaxone); and MS Lifelines (Rebif).