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Advocates Speak Out: Rob Gundermann of Alzheimer’s and Dementia Alliance of Wisconsin

Rob Gundermann is public policy director for Alzheimer’s and Dementia Alliance of Wisconsin. He spoke with Seniors Speak Out’s Nona Bear about issues seniors are facing in Wisconsin. Below is an abridged version of the interview.

Nona Bear (NB): What community do you serve and how long have you been advocating for patients?

Rob Gundermann (RG): We are based in Madison, Wisconsin and formed in the 1980s. Originally, we were part of the Alzheimer’s Association, and then years ago, we split off and created our own group.

NB: What changes have you seen the Part D program make in the lives of seniors?

RG: We’ve seen a tremendous change. When I started, we didn’t have any drug programs, so we were seeing people choose between buying food or their medicine. We also saw people cutting their dosages in half to make them last longer. So having this program where people can get their drugs affordably is tremendously helpful. Through Medicare, we have people going in to get their conditions addressed earlier and overall this is saving us money.

NB: What are some issues that seniors still struggle with regarding the Part D program?

RG: The issue I hear about most often is getting the donut hole filled. In Wisconsin, it’s even more complicated as we work with the system we had in place before Part D, our state program Senior Care. We’re still figuring that all out.

The number two issue though is the preferred drug list. Alzheimer’s is unique since there are only a few drugs to choose from to treat the illness. The latest generation drugs are better than the older generation, so we’re trying to get people on those medications. However, if seniors pick the wrong plan or the preferred drug changes on their plan, that becomes a big problem.

NB: Are people aware that the Medicare donut hole will be closed?

RG: Not yet, and currently there’s a lot of uncertainty because people aren’t sure where the ACA is headed. There needs to be more outreach to explain that this donut hole will close in time.

NB: You mentioned the importance of picking the right plan. Are your patients aware they can change plans during the course of the year if they have a one or two star plan? Does that impact your population?

RG: It absolutely does. As the coverage changes, their medications might not be covered. Part of our job is to educate them and make sure they review their plans before that window closes and make needed changes. That’s an issue that I think a lot of seniors in general need to be educated more about.

NB: What are some key questions seniors should discuss with their doctors and pharmacists in relation to their Part D coverage?

RG: They should ask about generics and mail order as two ways to save money. We also find some medications where it’s not any more expensive to get a higher dose, so you can get a higher dose and cut it in half to your actual prescribed dose to save costs, but obviously that’s something you should discuss with your doctor and pharmacist.

NB: How do you think changes to Part D would impact your constituents?

RG: We have two big concerns with potential changes to Part D. One is limitations on current medications. Aricept and Namenda are the two most recent drugs for Alzheimer’s. We are afraid that these medications could be removed from the preferred drug list and that there won’t be an alternative for patients. The other issue is ensuring there is access to new drugs, ones that could potentially stop the progression of the disease, through Part D, so that they are a treatment option for all, not just those who can afford to pay for the medication out of pocket.

NB: How would any changes to Low Income Subsidy affect the people you serve?

RG: Changes would reduce their ability to get their drugs and could delay the point at which they start taking these drugs. The goal with dementia is get patients on medications as soon as possible, so you can slow the onset of symptoms and delay institutionalization.