January 20, 2006

This Week in Washington
Senators Consider Legislative Fixes for Implementation Problems with Medicare Part D

In the News
One-Pill-A-Day HIV Regimen Shows Promise

Announcements
Research on Pathways Linking Environments, Behaviors, and HIV

This Week in Washington
Senators Consider Legislative Fixes for Implementation Problems with Medicare Part D
According to Congressional Quarterly (CQ) on Wednesday, January 18, Members of Congress are expressing concern over the number of problems that newly transitioned Medicare Part D beneficiaries are encountering as they attempt to access the new plan’s prescription drug benefits.*

In response to the numerous problems reported since Part D’s implementation on the first of this month, many Senators—both Democrat and Republican—are calling for reopening the Medicare Modernization Act (the legislation that created the Part D plan) for revisions, CQ revealed. As part of this effort, the article continued, Senators Olympia Snowe (R-ME) and Bill Nelson (D-FL) have submitted a bill to extend this year’s enrollment deadline from May 31 to December 31 without penalty. Earlier in the week, Senator John Rockefeller (D-WV) was planning legislation to reimburse the many Part D beneficiaries and the approximately 20 states for the money that they have expended to date to cover the costs of prescriptions.

The Administration has acknowledged that there have been some troubles in the program’s implementation, but they believe that the problems can be easily fixed, CQ reported.

As noted in The Washington Post on Wednesday, January 18, Department of Health and Human Services (HHS) Secretary Mike Leavitt remarked during a call with reporters that Part D enrolment has far exceeded early expectations, and the program was well on track to meeting its goals. However, he conceded that “caseworkers have responded to tens of thousands of complaints by seniors, pharmacists and others who could not get the correct medications at the correct price,” the Post stated. He therefore promised to “fix every problem as quickly as possible,” the newspaper indicated, adding that the Secretary is traveling around the country this week to gain a better understanding of the implementation problems to ensure swift resolution. The Post also reported that HHS has hired additional caseworkers to help process complaints about the prescription-drug benefit.

AIDS Action issued an Action Alert earlier this week recommending that Part D problems be reported to the Centers for Medicare and Medicaid Services (CMS) so that they can be quickly addressed. AIDS Action staff will continue to monitor the Medicare Part D Prescription plan and to keep readers informed of any legislation that is proposed to enhance this new benefit.

The Congressional Quarterly article referenced in this article is available online only to subscribers. To access The Washington Post article on which this brief is based, link to http://www.washingtonpost.com/wp-dyn/content/article/2006/01/17/AR2006011701376.html

*Medicare’s new prescription drug benefit, also known as Medicare Part D, was legislated to provide generic and brand-name prescription drug coverage for 43 million seniors and individuals with disabling conditions, including 90,000 people diagnosed with AIDS. Part D took effect for all Medicare consumers on January 1, 2006.

In the News
One-Pill-A-Day HIV Regimen Shows Promise
According to findings reported in a New England Journal of Medicine article by an international team of doctors,, a recently developed combination of three anti-retroviral medications “causes fewer side effects and appears to be easier for patients to tolerate,” according to Health Day News on January 18. Dr. Michael Horberg, who is the director of HIV/AIDS policy for the Kaiser Permanente Health Plan, affirmed in Health Day that the study’s findings are important because they validate a larger number of treatment options.

Created by two separate pharmaceuticals, the three medications—Sustiva, manufactured by Bristol-Myers, and Viread and Emtriva, manufactured by Gilead Sciences—are currently available in a two-pill regimen: Sustiva plus a Viread-Emtriva combination called Truvada, Health Day News explained.

The Washington Post, reporting on the same development, noted that this three-drug regimen is the most commonly prescribed for people new to HIV treatment. Further, the international team of doctors indicated that this regimen, which is used by 20% of “the market,” is slightly more effective than the runner-up regimen (used by 11%), the Post continued. And, as revealed in Health Day, fewer people using the more popular regimen stopped treatment because of side effects.

Now, news sources report, collaboration between Bristol-Myers and Gilead Sciences may result in the availability of a single-pill combination of these three medications before the year is over.

As outlined in the Post, when treatments for HIV first became available, regimens contained high numbers of medications and often required people to wake up at night to take their polls. These regimens also had complicated food restrictions. Thus, drew the Post, the introduction of a single-pill regimen would be a milestone.

According to the Post, the idea of a one-pill-a-day treatment holds “some kind of symbolic appeal”—even for individuals on a two-pill regimen. "I'm counting the days" until the new pill becomes available, Lucky Santana, who is on a two-pill regimen, told the Post. However, this anticipation is fueled by more than just an interest in reducing the frequency with which medications are administered, the newspaper reported. It is also fueled by an interest in containing the out-of-pocket costs for treatment, the paper continued; co-payments at the pharmacy can run $50 a month for every prescription. For example, when the new pill becomes available, Mr. Santana expects to save $30 every time he fills a prescription, noted the Post.

In Health Day News, Dr. Horberg affirmed, "We know that fewer numbers of pills a day is always going to lead to increased adherence." In addition, he said that fewer side effects will help individuals stick with their drug regimens.

The new pill will not, however, be the best option for everyone, the Post and Health Day News cautioned. Patients who are doing fine with their current drugs may have no reason to try different medicines, Dr. Horberg said in Health Day. Moreover, he warned, the new regimen could actually be harmful for some patients.

To read the articles on which this news brief is based, link to Health News at http://news.yahoo.com/s/hsn/20060119/hl_hsn/newhivdrugregimenmoreeffectivethanexistingtherapy; _ylt=AsIjtSiYgmdg7WRU5F54VrEGyLYF;_ylu=X3oDMTBjMHVqMTQ4BHNlYwN5bnN1YmNhdA-- and to the Washington Post at http://www.washingtonpost.com/wp-dyn/content/article/2006/01/18/AR2006011802428.html

Announcements
Research on Pathways Linking Environments, Behaviors, and HIV
The National Institutes of Health (NIH) is offering grants for research studies on the relationships among social environments, individual behaviors, and the incidence and prevalence of HIV and AIDS in populations. The following types of organizations are eligible to receive a grant: for-profit and nonprofit organizations; public or private institutions, such as universities, colleges, hospitals, and laboratories; units of state and local government; eligible agencies of the federal government; foreign and domestic institutions; faith-based or community-based organizations; and units of state and local tribal governments.

According to the funding announcement, it is anticipated that the size and duration of each award will also vary because the nature and scope of the proposed research will vary from application to application. Moreover, the total amount awarded and the number of awards will depend on the mechanism numbers, quality, duration, and costs of the applications received.

Applications deadlines are as follows: September 1, 2006: September 1, 2007, and September 1, 2008. The contact for this grant is Susan Newcomer, who can be reached by telephone at (301) 435-6981 or by e-mail at newcomes@mail.nih.gov. For more information on this funding opportunity, see http://grants.nih.gov/grants/guide/pa-files/PAR-06-114.html

The AIDS Action Weekly Update
The Weekly Update is written with a mind toward the interests of our members. If you are interested in membership with AIDS Action, we invite you to contact members@aidsaction.org.

AIDS Action
1730 M Street NW, Suite 611
Washington, DC 20036

Phone: (202) 530-8030
Fax: (202) 530-8031
Privacy Statement