Terry Russell

The National Alliance on Mental Illness of Ohio is the state’s largest mental health advocacy organization and represents more than 525,000 adults in Ohio who live with serious mental illness.

For the vast majority, the single most important element of their care is medication. A proposed change to Medicare’s Part D drug benefit will negatively affect nearly 2 million Ohio seniors and those who rely on Medicare for mental health medications.

When Medicare Part D, the prescription drug coverage for seniors and people with disabilities, was created 10 years ago, protections were put in place to ensure access to needed medications.

For example, the “protected class policy” requires Part D plans to provide access to “all or substantially all” drugs in six classes: antidepressants, antipsychotics, anticonvulsants, immunosuppressants, antiretrovirals and antineoplastics.

The Centers for Medicare and Medicaid Services wants to eliminate antidepressants and immunosuppressants from this policy in 2015 and antipsychotics in 2016.

The proposed regulation would dangerously limit treatment options and undermine affordable, high-quality care. For example, Medicare Part D now covers more than 20 generic antidepressant medications; the change would limit the options to nine. This significantly reduces both a patient’s choice and a doctor’s freedom to exercise clinical judgment.

Mental health medications are not “one size fits all.” Some people respond better to one medication or dosage than others. Patients experience different reactions and side effects. Age, gender, race, body size, body chemistry, other physical illnesses and their treatments, diet and smoking can also influence a medication’s effectiveness.

Therefore, the greater the range of medications offered, the greater the chance doctors and patients will find the right treatment option.

Officials at the Centers for Medicare and Medicaid Services believe limiting access to medications will save money. In reality, this is just not the case.

Limiting access often results in higher costs because it increases the risk of relapse and expensive hospitalization. In addition, incarceration, homelessness and even death are just some of the indirect costs which burden our communities and Ohio’s economy.

There are already tools in place to control Medicare prescription prices. Private Part D plans compete to deliver affordable coverage. They negotiate discounts and rebates with drug manufacturers and use the savings to reduce out-of-pocket costs.

The Medicare Part D program has a 94 percent customer satisfaction rate and costs 45 percent less than initial Congressional Budget Office projections. Clearly, the program is working for beneficiaries and taxpayers.

At a time when national attention is focused on improving mental health care, a rule restricting access to psychiatric medications does not make sense. My organization and hundreds of other patient and senior advocacy organizations strongly oppose these changes to Part D’s existing medication access policy.

Russell is the executive director of the National Alliance on Mental Illness of Ohio.