The Issue

Tens of thousands of Medicare beneficiaries depend on Xopenex®(levalbuterol HCl) Inhalation Solution for safe and effective treatment of asthma and chronic obstructive pulmonary diseases (COPD). But reimbursement incentives inadvertently created by the Medicare program that benefit racemic albuterol may divert Xopenex prescriptions away from patients who truly need them.

Recently, the Centers for Medicare and Medicaid Services (CMS) implemented a coding change that brought reimbursement levels for racemic albuterol and Xopenex® (levalbuterol HCl) Inhalation Solution under the Medicare Part B benefit to the same level. When CMS raised the reimbursement paid for generic albuterol while lowering the reimbursement for Xopenex, a new patient-care hurdle developed -- economic incentives for providers to refuse to fulfill prescriptions for Xopenex.

Physicians who treat patients with asthma and COPD understand the benefits of Xopenex over racemic albuterol. Although they may differ on whether or not Xopenex or generic albuterol may be better for a particular patient, most agree that quality-of-care and patient experiences are different. Patients should not be forced to take albuterol for economic reasons – especially if they have already failed on that drug and their physician has determined that Xopenex is a better treatment option.

Take action now and tell Congress that you want them to make sure that doctors are in control of their patients’ care, not retail pharmaceutical providers. Proposed legislation can ensure Medicare patients on albuterol are not saddled with a co-pay increase (20% of $1.31 as opposed to 20% of $0.20, adding up when the standard 30 day prescription is 120 nebules).