Medicare coverage for specific tests ends June 22
After June 21, Medicare will limit coverage for the core drug-sensitivity genetic tests that comprise YouScript’s Polypharmacy test panel.
This means that if you or a loved one are 65 or older and not taking the drugs Plavix, nortriptyline, amitriptyline or Xenazine, you will lose this Medicare benefit. Drug-sensitivity testing, also called pharmacogenetic testing, allows your doctor to know how your unique DNA could impact your response to many common drugs.
The recently released decision affects coverage of genetic tests for three members of the CYP450 family of drug metabolizing enzymes: CYP2D6, CYP2C9 and CYP2C19. After June 21, Medicare will only cover testing for CYP2C19 and CYP2D6, and then only for certain specific medications. CYP2C19 testing will only be covered for patients taking Plavix (clopidogrel). CYP2D6 testing will be covered for patients on amitriptyline and/or nortriptyline, both antidepressants, and Xenazine (tetrabenazine), a medication used to treat a specific movement disorder caused by Huntington disease.
The potential benefits of YouScript testing are many. YouScript pharmacogenetic testing can help patients avoid treatment failures and potentially harmful adverse drug reactions, often called side effects, and help doctors prescribe more effectively. This can be an especially challenging task when patients of Medicare age are concerned. Consider:
- The average elderly patient takes between four and five prescription drugs and two over-the-counter drugs
- About 12 percent of hospital admissions involving elderly patients are caused by adverse drug reactions. It’s estimated that more than half of these hospital admissions are preventable
If your 65 and older and on Medicare, we suggest you strongly consider advocating for yourself by talking to your doctor about ordering testing before this benefit is lost to you. Such testing can be done by any qualified testing laboratory. You can also order testing supplies directly from us, and we can talk to your doctor on your behalf.
If you have already been tested, we recommend sharing this blog post with any friends or loved ones who are on Medicare to let them know of the benefit they will be losing after June 21. Three out of four people have genetic variations that determine how their bodies process and use drugs, so it’s likely someone you know could benefit from the information YouScript testing provides.
Tell Us Your Story
Have you benefited from YouScript testing and want to tell your story? We want to talk to you! We’re looking for patients who know firsthand the difference this testing can make to tell their story to the media. Email us at: firstname.lastname@example.org.
Make Your Voice Heard
If this is an important issue to you, consider reaching out to your local lawmakers to make your voice heard. Let us know if you would like to be kept updated on a grassroots outreach campaign we’re preparing to spread information about the importance of pharmacogenetic testing.