[Congressional Record (Bound Edition), Volume 146 (2000), Part 7]
[Senate]
[Page 9514]
[From the U.S. Government Publishing Office, www.gpo.gov]



             ACCESS TO INNOVATION FOR MEDICARE PATIENTS ACT

  Ms. MIKULSKI. Mr. President, we are so fortunate to live in an era 
when modern medical breakthroughs are an almost common occurrence. 
Every day brings new research and insight into the human body and 
diseases that, unfortunately, affect our friends, families, co-workers, 
and ourselves. For example, there are several wonderful new therapies 
that help people with chronic diseases like rheumatoid arthritis, 
multiple sclerosis, and Hepatitis C live more active and pain-free 
lives. I am proud to be an original co-sponsor of the Access to 
Innovation for Medicare Patients Act (S. 2644), which would extend 
Medicare coverage to new self-injected biological therapies for these 
chronic diseases.
  One of the most important things I do as a United States Senator is 
listen to the people and the stories of their lives. The story of one 
of my constituents, Judith Levinson of Rockville, Maryland, is a 
compelling example of the power of these new therapies. Judith was 
diagnosed with rheumatoid arthritis (RA) when she was 40 years old. At 
first, her fingers and toes swelled up and sent sharp pains into her 
arms and shoulders. Over the next few years, she had multiple surgeries 
to place artificial knuckles in her fingers, to fuse her thumbs, and to 
replace both of her wrists with steel rods. Her feet have also been 
affected. Judith had six surgeries on her feet because bone 
deterioration made walking very difficult and painful. She now wears a 
size 2 shoe because so much bone has been removed from her feet. 
Unfortunately, Judith's suffering did not end with the surgeries. 
During recovery, her hands had to be placed in cages in order to heal 
properly--which made her completely dependent on others for daily 
activities. On a scale of 1 to 10, Judith rated her daily pain as an 8.
  In January of 1999, Judith's doctor prescribed a new self-injectable 
drug called Enbrel, which had just been approved by the Food and Drug 
Administration (FDA) for the treatment of advanced RA. I am proud to 
add that the Johns Hopkins University's Division of Rheumatology was 
instrumental in the development of this breakthrough therapy as one of 
its clinical trial sites. Judith says that, within five weeks, she had 
less swelling in her fingers and she had more energy. As she puts it, 
she is in ``go mode.'' I am happy to report that Judith has resumed 
writing, takes daily walks with her family without stopping at every 
street corner, and truly believes that this treatment has changed her 
life.
  Judith is fortunate in that her insurance plan covers the cost of 
Enbrel, with a small co-payment. Medicare, on the other hand, does not 
allow coverage of self-administered injectable drugs. It covers only 
drugs that are administered in a physician's office. That means that 
many Medicare beneficiaries are going without treatment because they 
can't afford it themselves, or that they are treated with a therapy 
that is covered but may not be the most appropriate or effective 
treatment. That doesn't make sense. I am very proud that most of the 
breakthroughs in medicine today were invented in the United States. But 
breakthroughs alone aren't enough--I believe that every American ought 
to have access to those breakthroughs. Medicare patients are certainly 
no exception.
  It is gratifying that this legislation is supported by a broad range 
of women, senior, minority, religious, rural, and health professional 
organizations like the Alliance for Aging Research, the American Public 
Health Association, the National Farmers Union, the Older Women's 
League (OWL), the National Hispanic Council on Aging, and more than a 
dozen other organizations. OWL, the only national membership 
organization that works on the issues unique to midlife and older 
women, has stressed the importance of access to innovative medical 
treatments for older women and urged Congress to recognize that ``73% 
of women on Medicare have two or more concurrent chronic conditions, 
which often lead to limitations in the activities of daily living and 
the need for long-term care. In order to improve the health of women 
suffering with chronic diseases . . . Congress should extend Medicare 
coverage to self-administered injectables.''
  Mr. President, we must ensure that Medicare beneficiaries have access 
to promising and innovative new therapies. This legislation will help 
thousands of people living with chronic conditions like RA, MS, and 
Hepatitis C live better, happier, and more productive lives. I urge my 
colleagues to join Senators Gorton, Murray, myself and the other co-
sponsors in supporting it.

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