Ultimately, she said, “we hope it means less expensive drugs for treatment for your patients. What does it actually mean? We don’t know.”
PBMs have been a major legislative focus and will likely continue to be a top issue in the next legislative year, Ms. McDaniel said. They represent a “common ground” between the pharmaceutical industry’s priorities and physicians’ priorities, she said.
The way PBMs have priced biosimilars underscores the need for reform, she said. “What it does do is negate yet another argument that PBMs make, which is that they are a good influence on the market and that they have this benefit to patients.”
Positive Change
Christina Downey, MD, chair of the ACR Government Affairs Committee and associate professor of medicine in rheumatology at Loma Linda University, California, said the importance of advocacy efforts is greater than ever because “it’s getting really tough to be a physician” due to reimbursement concerns, medical accessibility and other challenges.
The committee and ACR staff have made strides in a variety of areas, she said. The Safe Step Act reduces barriers to access by codifying medical exceptions to step therapy protocols. Workforce struggles prompted the Resident Physician Shortage Reduction Act, which adds 14,000 Medicare-funded graduate medical education positions. And the Pharmacy Benefit Manager Transparency Act aims to address high drug costs.
She urged ACR members to get involved in the efforts.
“We do have a way to make positive change,” Dr. Downey said. “We still have a say in what happens to our profession. But we only have a say when enough of us get loud enough to be heard.”
Thomas Collins is a freelance medical writer based in Florida.
