Landover, Md., February 2, 2021 — The Epilepsy Foundation and its partners call on the Biden Administration to rescind a demonstration announced by the previous administration that would severely limit access to anticonvulsants (also known as anti-seizure medications) for the 1.1 million Medicare beneficiaries living with the epilepsies.
On its final full day, the previous administration announced a demonstration program that would enable Medicare Part D plans to opt out of the Six Protected Classes policy starting in 2022 (with a delay for one of the classes, antiretrovirals, which would start in 2023). Medicare’s Six Protected Classes has broad bipartisan support and was established to ensure that people with particularly vulnerable health conditions, such as the epilepsies, have access to the full range of treatments approved by the U.S. Food and Drug Administration (FDA). Under the demonstration, Part D plans would no longer have to cover all or substantially all anticonvulsants and instead, could cover only one drug per therapeutic class—which is even less than Part D’s standard for non-Protected Class medications of two drugs per class.
Epilepsy is a spectrum condition with a wide range of seizure types and seizure control varying from person to person. With advances in genetics, imaging, and mechanistic understanding, a growing number of people are known to have a rare form of epilepsy.
“Given its complex nature, epilepsy medications are not interchangeable,” said Dr. Jacqueline French, Chief Medical and Innovation Officer, Epilepsy Foundation; and Professor, Comprehensive Epilepsy Center, NYU Langone Health. “If people with the epilepsies do not have access to the most effective anticonvulsant(s), their risk of breakthrough seizures and related complications — including injury, disability and even death — vastly increases.”
Weakening the Six Protected Classes policy will also result in higher costs to Medicare, as epilepsy-related medical costs associated with uncontrolled epilepsy are two to 10 times higher than costs associated with controlled epilepsy.
“These classes of medications were protected for a reason,” said Amy Brin, MSN, MA, PCNS-BC, Chief Executive Officer and Executive Director, Child Neurology Foundation; and Chair, Epilepsy Leadership Council. “Allowing Part D plans to so drastically restrict coverage of anticonvulsants is dangerous and potentially life-threatening for people with the epilepsies.”
American Epilepsy Society (AES)
The Brain Recovery Project
Child Neurology Foundation
Dravet Syndrome Foundation
Epilepsy Leadership Council (ELC)
Hope for ULD™
Glut1 Deficiency Foundation
Gould Syndrome Foundation
Hope for Hypothalamic Hamartomas
International Foundation for CDKL5 Research
National Association of Epilepsy Centers (NAEC)
Rare Epilepsy Network (REN)
SynGAP Research Fund (SRF)
Tuberous Sclerosis Alliance
Wishes for Elliott/DEE-P Connections
For more information about epilepsy or other advocacy efforts, please visit epilepsy.com/access-to-medications.
According to the World Health Organization, epilepsy is the most common serious brain disorder worldwide, with no age, racial, social class, national or geographic boundaries. The U.S. Centers for Disease Control & Prevention (CDC) estimates that 3.4 million people in the United States are affected by epilepsy, or approximately 1 in 26 people. Epilepsy is the underlying tendency of the brain to produce seizures, which are sudden abnormal bursts of electrical energy that disrupt brain functions. In addition to those diagnosed with epilepsy, one in ten people will have a single seizure in their lifetime.
About the Epilepsy Foundation
With a network of partners throughout the United States, the Epilepsy Foundation is leading the fight to overcome the challenges of living with epilepsy. The Foundation connects people to treatment, support and resources; leads advocacy efforts; funds innovative research and the training of specialists; and educates the public about epilepsy and seizure first aid. For more than five decades, the Epilepsy Foundation has shone a light on epilepsy to promote awareness and understanding, and to advocate for laws that matter to people with epilepsy, while also funding epilepsy research and supporting epilepsy investigators and specialists in their early careers. In partnership with the CDC, the Epilepsy Foundation has helped to improve access to care for people with epilepsy, expanded its digital reach and online resources in homes across the country, and trained more than 600,000 people in seizure recognition and first aid. The Epilepsy Foundation has also assisted more than 140,000 people through its 24/7 Helpline, and continues to focus on innovation, new therapies, community services, advocacy and education as key priorities. To learn more visit epilepsy.com or call 1.800.332.1000. Follow us on Facebook and Twitter.
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