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AGS POSITION STATEMENT Medicare Prescription Drug Statement of Principles *Last Updated in 2000* Clinical Practice Committee The American Geriatrics Society (AGS), an organization of over 6,000 geriatricians and other health care professionals who are specially trained in the management of care for frail, chronically ill older adults, supports a voluntary prescription drug benefit that is affordable and accessible for Medicare beneficiaries. The addition of a Medicare drug benefit should be consistent with an overall plan to strengthen and modernize Medicare. In this regard, we put forth the following principles. 1. Adequate Financing. We support adding a prescription drug benefit under the Medicare program that is financed through mechanisms that bring in sufficient revenue to support the costs of the program, without further requiring reductions in the payments for other services or reduced Medicare benefits in other areas. 2. Beneficiary Access to Medications. Beneficiaries should have access to necessary medicines. Formularies must be developed by individuals directly involved with patient care and must ensure use of necessary medications for the elderly. In addition, formularies must accommodate the special needs of frail older persons, such as the needs of older people who reside in long-term care settings. 3. Continued Innovation. Appropriate use of prescription drugs is the mainstay of effective treatment for many of the most common and dangerous chronic conditions of older Americans. Making sure that financial barriers do not deprive older patients of needed medications, while ensuring continued innovation and development of lifesaving drugs, is essential. 4. Off-Label Uses. We recognize the need to furnish covered drugs for off-label uses. For this reason, prescribers should be able to furnish covered drugs for off-label uses. 5. Protection from the Cost of Prescription Drugs. A Medicare drug benefit should assist older adults - especially those with low-incomes - with the high cost of prescription drugs and protect them against excessive out-of-pocket costs. Such a benefit should give beneficiaries the bargaining power in the marketplace they lack today. Any benefit should assure access to all medically necessary drugs. 6. Medication Monitoring and Coverage. Inappropriate prescribing and polypharmacy are major causes of morbidity and mortality for older Americans. Therefore, a Medicare drug benefit must include coverage of medication management and monitoring in order to: a) reduce the risk of medication-related problems and medication errors, b) provide patient education, c) optimize outcomes and d) reduce cost. Reimbursement to all health-care professionals who provide these services must be covered under the benefit. Developed by the AGS Clinical Practice Committee (prepared on behalf of the CPC by Susan Emmer, Esquire, AGS Washington Representive; Todd Semla, PharmD; Martin Gorbien, MD; Anthony Ranno, PharmD; and Jane Potter, MD) and the AGS Public Policy Advisory Group and approved by the AGS Board of Directors, May, 2000.AGS, The Empire State Building, 350 Fifth Avenue, Suite 801, New York, NY 10018.
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