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Medicare previously reimbursed these expenses only for patient self-testers who had mechanical heart valves. The new coverage expands to includethose on anticoagulant medication with chronic atrial fibrillation and venousthromboembolism.
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"This expanded coverage will give more warfarin patients the flexibilityto test when and where they want," said Dr. Alan Jacobson, cardiologist, LomaLinda University School of Medicine. "Now, patients who travel extensively orwho have difficulty with access to their doctor's office or a centralizedlocation can monitor their INR at home. If they test more often, it's easierto manage their therapy and keep their medication in the therapeutic range."
Some patients travel to their doctor's office or an anti-coagulationclinic as often as once a week to make sure their warfarin is appropriatelyregulated. While warfarin is commonly prescribed to prevent thrombosis, orblood clots, it must also be carefully monitored to prevent bleeding.
Portable, handheld prothombin time (PT/INR) meters, like the CoaguChek(R)XS System for Patient Self-Testing, enable patients to test their clottingtime at home in about a minute, using a small drop of blood from a simplefingerstick. Currently, in the United States, less than 5 percent of patientson blood thinners perform self-testing, according to the Centers for Medicareand Medicaid Services.
Studies suggest that anticoagulation patients who self-test may experiencefewer complications overall than those who do not, because self-testing mayincrease patient time in therapeutic range.(1) Studies also suggest thatPT/INR self-testing (performed with a blood sample from a fingerstick) is justas accurate as fingerstick testing performed by a healthcare professional andconventional testing performed on a laboratory analyzer.(2,3,4)
"I feel comfortable with more of my patients monitoring from home becausehandheld meters like the CoaguChek XS System are easy to use, and I know theresults will be as reliable as results from our office meter and from thelab," said Dr. Jacobson. "Plus, this gives my patients the convenience oftesting at home with a simple fingerstick rather than having blood drawn fromtheir arm and waiting for lab results."
Under the new Medicare B policy, the patient portion of costs for self-testing is expected to be about $30 a month (based on a national average) forthe use of a PT/INR meter and test strips, and about $35 for the initialtraining. Patients with supplemental insurance coverage could potentially havelittle or no out-of-pocket expenses.
All patients on anticoagulant medication need a prescription from theirdoctor for a self-testing meter and supplies before being able to monitortheir own clotting time at home. Patient self-testing is also designed toaugment, not eliminate, testing and therapy management that is overseen by adoctor. Patients who self-test notify their doctors of clotting time resultsso they can make the proper adjustments to medication.
Patients interested in finding out more about self-testing their PT/INRshould talk to their doctor. For more information on the CoaguChek XS Systemfor Patient Self-Testing, visit www.ASmartWayToTest.com.
About Anticoagulation Monitoring
Certain patients with atrial fibrillation, a mechanical heart valve ordeep vein thrombosis require protection against thrombosis, or blood clots.They are typically put on lifelong oral anticoagulation therapy with warfarinsodium (e.g., Coumadin) to thin their blood. Each
