- The Washington Times - Sunday, November 9, 2003

Thousands of Medicare beneficiaries suffering from Multiple Sclerosis (MS) are awaiting the outcome of congressional deliberationsonthe Medicare prescription drug bill. For people who are either over 65 or disabled and living with MS, Medicare is an important piece of the financial puzzle in treating diseases like MS.

I can still remember the day I was diagnosed with MS, a debilitating and chronic disease of the central nervous system. After years of misdiagnosis and no treatment, I was finally diagnosed in 1999. The diagnosis answered a lot of questions, but raised many more, including what medications were available to treat it.

I’ve been pretty fortunate as an actor, so concern with medical expenses has not been an issue; but for many it is the issue. While I have been able to continue to work with the benefit of an injectable medication that slows the progression of the disease, many people aren’t as fortunate.

In 2002, I decided it was time to go public with my story and use my celebrity to help others with MS who are facing similar challenges every day.

Cutting-edge research and medical advances provide tremendous hope, as well as efficiencies of care and long-term cost savings. But without a coverage process that is flexible enough to incorporate the latest medicines and delivery systems, only those Medicare beneficiaries who can afford to cover the costs themselves will benefit. That’s not right. Those who are Medicare eligible and living with chronic illnesses like MS should have access to the treatment options that they and their doctors decide are best for them. Fortunately, some in Congress have recognized this inequity and are taking bold steps to correct it.

Sens. Charles Grassley, Iowa Republican, and Kent Conrad, North Dakota Democrat, have joined hands to sponsor outpatient coverage for Medicare patients who require injectable therapies for several chronic illnesses, including MS. Medicare used to cover injections that were administered in a Medicare-participating physician’s office. Unfortunately, coverage for three MS therapies was eliminated in January 2003, because the shots are subcutaneous rather than intramuscular.

I think that’s putting way too fine a point on an issue as serious as drug coverage for people with a debilitating disease like MS. Now, without the coverage, patients who can afford it have been paying out-of-pocket. For those who can’t afford to pay out of pocket, they are using drugs that may not be as effective for them. Or worse, they are going without treatment altogether, which will only cost the Medicare system more as their relapses increase, and they require more hospitalizations, or nursing home and home health services.

Congress has an opportunity to fix this problem as part of the prescription drug bill now being debated. The Grassley-Conrad legislation would allow coverage of a therapy that is a complete replacement for an existing covered therapy. In other words, subcutaneous shots for MS will be covered, as well as those that are intramuscular.

In the next several days, Congress will wrap up negotiations on the Medicare bill. On behalf of those who live with chronic illnesses like MS and who don’t have a platform to encourage policy-makers to do the right thing, I urge Congress to recognize the wisdom of these two senators and enact this bill with their provision intact. The universe of patients who will be helped is not necessarily large, but they desperately need your leadership to be able to enjoy the best quality of life with this disease.

Teri Garr is an actress.

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