Congress and President Clinton can’t get together soon enough for elderly Americans in search of a break on prescription drug prices.
One of the few remaining Chicago managed-care plans that offers discounts on prescription drugs to Medicare recipients is no longer accepting new Medicare enrollees as part of a business decision by its new owner, according to a letter recently sent to its area subscribers.
Wellpoint Health Networks confirmed a recent decision to stop accepting patients into its Medicare HMO run by subsidiary Unicare Health Plans. Thousand Oaks, Calif.-based Wellpoint said that the move is simply a business decision in connection with its acquisition this year of Chicago-based Rush-Prudential Health Plans, now known as Unicare.
“We are not accepting new [Medicare] members, but there are no changes for existing members,” Wellpoint spokesman Larry Bryant said.
Currently, Wellpoint’s local Medicare plan covers nearly 3,500 seniors in Cook, DuPage, Lake and Will counties, according to the Health Care Financing Administration, which administers the Medicare health insurance program for elderly and disabled people.
Unlike other Medicare HMOs, Unicare’s senior plan here is reimbursed based on what general medical care costs have been in the past.
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Other Medicare HMOs, which are considering cutting back on enrollment of seniors because such patients are unprofitable, are reimbursed fixed monthly fees. Among those so-called Medicare risk plans, Hartford-based Aetna Inc. is evaluating whether to continue offering seniors benefits at all. Aetna’s decision is expected by the end of the month.
Meanwhile, until President Clinton and Congress can come together on whether to expand Medicare to include a prescription drug benefit to all seniors, managed-care plans for Medicare are the only way seniors can secure free or very low cost prescriptions short of an expensive supplemental insurance plan, senior advocates say.
More delegates: When the American Medical Association convenes its annual meeting in Chicago this weekend, the 153-year-old doctors group will be more representative of its 300,000 members.
The AMA has expanded the size of its governing House of Delegates to 550 from 497 a year ago, the Chicago-based association said.
Specialty societies now have one delegate per 1,000 members, up from one delegate per 2,000 members previously, the AMA said.
“Most people say, well you at the AMA only represent about 30 percent of the nation’s physicians, but we are still the largest of the representative bodies,” said Dr. Ted Lewers, the AMA’s chairman.
“When you now take in all of the geographic and specialty societies, we effectively represent 94 percent of the nation’s physicians through these groups” he said.
The AMA meeting begins Saturday and runs through June. 15.
Abbott’s plans: Abbott Laboratories is seeking accelerated regulatory approval for its anti-AIDS drug ABT-378 in a move that could give a much-needed boost to the company’s drug sales by the end of the year.
Abbott last week submitted a new drug application to the Food and Drug Administration for approval.
Abbott hopes to have the drug approved within six months, a much shorter time than for typical applications.
ABT-378 is one of a class of powerful drugs known as protease inhibitors hailed for their effectiveness in combating the human immunodeficiency virus that causes AIDS.
Because ABT-378 has proven effective in people with the AIDS virus who either haven’t been able to take other treatments because of side effects or have become immune to existing therapies, Abbott may indeed receive accelerated approval.
Analysts say the drug could eventually generate $500 million in annual sales in a few years. That’s nearly twice the $250 million in worldwide annual sales Abbott currently reaps from Norvir, an anti-AIDS virus protease inhibitor that has been on the market for four years.
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E-mail Bruce Japsen at [email protected]