Congress examines how to get medical innovations to seniors on Medicare

WASHINGTON D.C. — Lawmakers are trying to figure out how to get lifesaving medical innovations to our most vulnerable citizens. Congress is evaluating Medicare coverage of new drugs and devices for seniors.

Sue Wronsky’s mom, Lynn, was diagnosed with Alzheimer’s in 1991. She was just 63 years old.

“Back then the diagnosis process was often longer than it is now, and she had been showing symptoms of the disease for a few years,” Wronsky told lawmakers.

Lynn died in 2002.

“Our entire family became caregivers,” Wronsky said. “Travel plans went by the wayside and long-planned projects went on the back burner.”

Wronsky is now an advocate for the Alzheimer’s Association. She’s one of several witnesses to testify on Capitol Hill. Lawmakers are examining how Medicare decides to cover medical innovations like drugs and devices.

“The benefits of these treatments will only be realized if patients have access,” Wronsky said. “With Alzheimer’s, it is all about time and the last thing we need is more roadblocks.”

The Centers for Medicare and Medicaid Services makes coverage decisions based on whether the innovations are reasonable and necessary for the Medicare population. Experts said the process and timeline often differ from private insurance.

“Patients are dying every year,” Dr. Lishan Aklog, M.D., Chair and CEO of PAVmed, said. “If it’s a two- or three-year path to get to that point of coverage, then thousands of patients would have died.”

Those in the industry hope Congress can come up with proposals that increase both access and innovation.

“We need a predictable process,” Dr. Todd Brinton, M.D., Corporate Vice President, Advanced Technology Chief Scientific Officer at Edwards Lifesciences, said. “Actually, coming up with timelines that are quite clear -- anything that does that, improves patient care.”

For advocates like Sue, improving patient care could also mean saving lives.

“I’ve got some time left on this earth and I’d like nothing more than during my lifetime to witness the end to this horrible disease,” she added.

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