Standing against specialty tiers
Specific legislation to address the problem of high copayments for specialty drugs, the Patients’ Access to Treatments Act (H.R. 2999), would establish cost-sharing limits and prevent insurers from using drug formulary specialty tiers to limit access to needed therapies. It has been the ACR’s marquee legislative target for the past three Congresses, and its champion, Rep. David McKinley (R-W.Va.), has introduced the bill several times. “The ACR remains committed to increasing patient access to therapies that help our patients control their potentially disabling diseases like rheumatoid arthritis,” Dr. Worthing said.
Starting the conversation about pharmacy benefit managers
Concerns about drug pricing and, in particular, the practices of pharmacy benefit management (PBM) companies, were a high priority for the ACR’s September Advocates for Arthritis Capitol Hill visits and were discussed in several sessions at the Annual Meeting. Advocates’ concerns about access to high-cost drugs for their patients threatened by rebates and other PBM practices have now been taken up by Congress.
Drug pricing issues were aired in a series of hearings by the Senate Committee on Health, Education, Labor and Pensions. At a hearing in October, both Democratic and Republican committee members asked questions about high drug prices and the effects of rebates, and called for greater transparency in PBMs’ pricing practices. “These hearings are critical, because they are helping get the conversation started about PBMs,” Dr. Worthing said.
A Call to Action: Join RheumPAC Now to Lend Your Voice in 2018
The rheumatology field has its work cut out in 2018. Many changes and challenges will be coming to fruition in the New Year, not the least of which are the Medicare Part B drug/MIPS challenges, which Angus Worthing, MD, ACR Government Affairs committee chair, has described as “the perfect storm.” Why? Because if we in the rheumatology field don’t do our part via legislative action to reverse the CMS’ plan to adjust Part B drug costs, most ACR/ARHP members will be forced to stop supplying Part B drugs to their patients, causing major patient access to treatment issues.
So we are calling on ACR/ARHP members to do their part to help. Make an investment in rheumatology’s future by giving to RheumPAC before the end of the year. (Note: Only U.S. ACR/ARHP members may make RheumPAC investments.) Let your voice be heard for the good of your patients and practices.
Larry Beresford is a freelance medical journalist in Oakland, Calif.
