Jack Stanfield wrote:
<<I have been on Ropinerole /re-quip for some 5 years (I think) In any
event,
I have done reeasonably well on re-quip. When I reached 65 I lost my
Blue
Cross medical insurance and I am attempting to obtain my medicine
through
the Veteran's Administration program. Unfortunately, I have discovered
that
while Sinemet is available from the VA -- Re-Quip is not. ...>>
Jack, when I was first prescribed ReQuip shortly after it went on the
market about 5 years ago, my HMO also rejected the claim because it was
not yet on their formularly. It took a lengthy discussion (and i think
some arm twisting) by my neuro with the HMO to explain why both Sinemet
and Requip were being prescribed and why they should both be covered, and
they eventually did cover it. But this was at least 5 years ago - it is
no longer a new drug and i think has now become accepted drug therapy for
PD. Of course I was dealing with a local HMO, not the VA.
The ReQuip problem seems to be part of the larger health care issue of
prescription drug coverage, or lack of it, and of many HMO's now dropping
Medicare beneficiaries. Here's some information from VA and congressional
web sites:
Ropinerol (ReQuip) is listed as a Class III (non formularly) drug in the
VA's formularly. It states:
"Non-formulary or restricted anti-parkinson agents require neurology
approval. " They won't accept a prescription from your own neurologist.
Another PD med in class III is tolcapone (Tasmar). Pramipexole (Mirapex)
- another dopamine agonist is in class II - Formulary with restrictions -
it also requires VA approval.
SEE: http://www.va.gov/visns/visn02/network/formulary.html - VISN2
Formularly List
Also see: http://www.vapbm.org/PBM/menu.asp - web site for Pharmacy
Benefits Management, Strategic Healthcare
Group , Department of Veterans Affairs.
How difficult is it to obtain a prescription for ReQuip and other
non-formuilary drugs from a VA physician? Has anyone else had experience
with this? Surely others must be facing similar problems.
There is a bill currently in the House that addresses these issues - H.R.
1136
Here is the THOMAS <thomas.loc.gov> record for it :
Sponsor: Rep Wicker, Roger F.(introduced 3/20/2001)
Title: To amend title 38, United States Code, to require Department of
Veterans Affairs pharmacies to dispense medications to veterans for
prescriptions written by private practitioners, and for other purposes.
STATUS:
3/20/2001:
Referred to the House Committee on Veterans' Affairs.
4/10/2001:
Referred to the Subcommittee on Health.
9/6/2001:
Subcommittee Hearings Held.
There are currently 47 cosponsors, but like many other health care
issues, it's unlikely to get out of committee this year. You can find a
committee hearing about it:
http://veterans.house.gov/hearings/schedule107/sept01/9-6-01/witness.htm
It includes the testimony of Representative Roger Wicker (MS), who
introduced the billl, and also testimony against the bill by some
representatives of veteran's organizations who oppose it because they
believe it will cost the VA too much money, and hurtr other programs.
However Rep. Wicker states that:
"A model for the implementation of this expanded service could be the
Department
of Defense, which has for years allowed private physicians to write
prescriptions which
are filled by the Military Health Services System. The Department of
Defense currently
fills approximately 30 million prescriptions a year which are written by
civilian
physicians, about one-half of the total number of prescriptions which are
handled. The
military does not require a second visit to a military physician...."
These are the members of the House Committee on Veteran’s Affairs
Subcommittee on Health
Jerry Moran, KS Chairman
Cliff Stearns, FL, Vice Chairman
Bob Filner, CA, Ranking
Howard (Buck) McKeon, CA
Ronnie Shows, MS
Jim Gibbons, NV
Shelley Berkley, NV
Mike Simpson, ID
Ciro Rodriguez, TX
Richard Baker, LA
Luis V. Gutierrez, IL
Rob Simmons, CT
Vic Snyder, AR
Ander Crenshaw, FL
Lane Evans, IL,
Henry Brown, SC
If coverage for ReQuip is denied by the VA, you might also contact your
Representative and ask if he or she could help you.
Good luck!
Linda
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