After successfully working with national providers RxAmerica and Medco, the Alzheimer's Association is excited to announce that Caremark/Silverscript has also agreed to remove its prior authorization policy for Alzheimer drugs for Medicare Part D beneficiaries. This applies to all FDA-approved Alzheimer medications: Aricept, Exelon, Razadyne and Namenda.

Policy reversals by these three major national providers help ensure access to Alzheimer drugs for Medicare beneficiaries enrolled in prescription drug plans and represents a significant advocacy victory for individuals with Alzheimer’s disease, their families and caregivers. The Association continues to advocate on behalf of those affected by Alzheimer’s disease to address issues related to Medicare Part D.

Under prior authorization, a drug plan can establish certain criteria that must be met before it decides to cover treatments. Sometimes the restrictive criteria inappropriately includes a score on the Mini Mental Status Examination (MMSE), which does not account for other factors such as an individual’s level of function in daily life or educational and cultural factors that could adversely influence a test score. The result could mean individuals with Alzheimer’s may not receive medications they need.

It is the Association’s position that the doctor-patient relationship should be at the core of medical treatment and that only a clinical judgment of the treating physician in conjunction with the patient/family should determine whether or not a drug is appropriate for a patient and for how long.

For more information about Medicare Part D, see our Medicare Drug Benefit page. To report a Medicare Part D-related problem, contact Leslie Fried.