OK, here's the skinny. A co-worker of mine made a point to tell me that ObamaCare is biting her father right in the butt. The situation is that apparently, allegedly, her father cannot any longer (as of August 1st) get his injections for Wet Macular Degeneration, and the fault was due to Obamacare and a new government agency that is trying to ration health care. I of course expressed doubt, and received the following email, which I'll place below the squiggle because... well... squiggle.
Starting 1 August, Medicare must approve the injection of drugs to treat wet macular degeneration. This will be to your (the patient's) disadvantage as it will delay your treatment. The Retina Group of Washington (RGW) now has to send photos of your eye(s) to Medicare for their review. If they approve the injection, RGW will be advised. RGW will then request from the manufacturer (Genetech) the dosage required. Genentech will send a "Patient Specific" dose to RGW. RGW will then call the you (the patient) and set an appointment for the injection of the drug. In my case it is Eyelin, the most expensive of the three drugs used to treat wet AMD.
The Dr said that until now, RGW kept large vial amounts of the drug on hand. Now, we can only wait to receive the drug with your name and it cannot be used for any other patients.
The change has been made to reduce the cost of drug treatment for wet AMD as the Health and Human Services study undertaken for the Independent Payment Advisory Board is of the opinion that under the Affordable Care Act the government (Medicare) can better control the costs by limiting the need for injections. The Independent Payment Advisory Board was created as part of the Affordable Care Act to find ways to control Medicare costs.
Now, one thing I was able to look up was the fact that the IPAB doesn't even have any members yet, so it's doubtful they're to blame. But that fact was dismissed, because, well, the doctor wouldn't lie. If anyone has any more information that could help clear things up that would be lovely.
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Apologies, I should include the response to the fact that the IPAB is yet unmanned...
The bottom line is that starting August 1, Medicare has been directed to ration drugs for wet AMD by requiring physicians to submit patient eye photos to Medicare, wait for approval from Medicare and then wait for the drug to be delivered, which they can then administer to that specific patient, instead of keeping a stock on hand and administering it as they see fit. My question is , who is behind this change? Regardless of whether it’s the IPAB, HHS or some other government bureaucracy, its still a government bureaucracy dictating to doctors how they can treat their patients in order to cut costs. The IPAB’s initial purpose is to recommend cuts in Medicare costs, so this is exactly the type of thing it will be doing. I will have my father get details from the doctor the next time he goes for a checkup.
This information apparently came from the eye doctor.