Investments in Legislative Advocacy Pay Off for Ohio Association of Rheumatology

During the OAR Advocacy Day at the Ohio Statehouse on May 4, 2017, are: Dr. Ott, in the black suit, flanked by three OAR board members, a CNP and thre residents from the Internal Medicine and Family Practice residency programs at Fairfield Medical Center in Lancaster, Ohio.

Like many other state rheumatology associations, the Ohio Association of Rheumatology (OAR) has recently been actively advocating for patient care at the state legislative level. The most recent example of OAR’s efforts included an Advocacy Day on May 4, when members met with state legislators to discuss topics of interest. It was the fourth such event for OAR. Topping the current advocacy agenda are Senate Bill 56 and its companion bill in the House, HB 72, which aim to reform step therapy protocols by, among other things, requiring that an insurer’s process for requesting a step therapy override be transparent and available to the provider and patient; and by allowing automatic exceptions to step therapy requirements under certain conditions, such as when the patient is stable on a prescription drug for the medical condition under consideration.

Similar to step therapy reforms recently passed in Texas, the goal is to ensure that step therapy programs are based on clinical guidelines developed by independent experts rather than solely on monetary considerations.

Step, or fail-first, therapy is a concern to many rheumatologists, notes OAR President Stephanie J. Ott, MD, FACR, a rheumatologist with Fairfield Medical Center in Lancaster, Ohio. For example, one of her patients was doing well with CellCept to manage her scleroderma, but was forced to stop the medication when she switched insurance carriers.¹ Now, the patient is not doing as well and is on medication for pulmonary hypertension, says Dr. Ott.

Successes at the State Level

Dr. Ott introduced the idea of policy advocacy to the OAR Board of Directors after she had experienced spring advocacy days through the ACR. (She is a member of both the ACR Government Affairs Committee and the ACR’s Affiliate Society Council.) She has met with many of her state legislators personally and has found they want to learn about these issues. She says, “Sometimes, you are able to get a little more bipartisan work at the state level because it’s in everyone’s best interest to work together.” With ACR and Arthritis Foundation support, OAR has now seen passage of legislation regarding streamlining of prior authorization, as well as use of biosimilar medications.

Annual Meeting Additions

OAR and ACR Advocacy Updates will be presented when the 12th Annual Meeting of the OAR convenes Aug. 25 at the Greater Columbus Convention Center. Two of the key scientific sessions feature Michelle Petri, MD, MPH, professor of medicine and director of the Lupus Center at The Johns Hopkins University’s School of Medicine, who will present an update on SLE and discuss new developments regarding antiphospholipid syndrome. This year’s meeting will also add a new breakout session on practice management and a poster presentation section for fellows.

Steps for Effective Advocacy

Having worked with state legislators, Dr. Ott furnished some advice to other state rheumatology associations that may be contemplating similar actions:

• Know your audience: legislators may not have been medical professionals, so furnish good handouts that clearly explain the issues and problems.
• Limit your talking points: “At the most, you will have 15–20 minutes with the representative.”
• Hone your message: “Explain your message as you would to a family member,” Dr. Ott counsels. “Partner with the Arthritis Foundation or include a patient who can present a personal story in a succinct way.”
• Reach out to the ACR: “If you’re not sure how to effectively advocate, the ACR is more than willing to help you learn these skills.” Dr. Ott suggests contacting the ACR’s Affiliate Society Council, the Insurance Subcommittee or the Government Affairs Committee. Visit the ACR’s Legislative Action Center.
• Finally, Dr. Ott offers her colleagues the opportunity to reach out to her. “I’m always willing to answer questions to help another state or another person do this,” she says.
• “I’m a big believer [in the idea] that if we want to really focus on the practice of rheumatology, where we can just take care of patients in the way we feel is best, then we also have to focus on all of the policies that affect that.”

Gretchen Henkel is a medical journalist based in California.

Reference

1. Omair MA, Alahmadi A, Johnson SR. Safety and effectiveness of mycophenolate in systemic sclerosis. A systematic review. PLoS One. 2015 May 1;10(5):e0124205. doi: 10.1371/journal.pone.0124205. eCollection 2015.