Rheumatology Patients & Providers Push for Step Therapy, Workforce Changes

Attendees met with 117 legislators during the event.

Editor’s note: Read a first-person account of the event from Angus Worthing, MD, FACR, FACP, below.

On Sept. 9 and 10, 2019, 112 rheumatology advocates visited 117 of the nation’s top lawmakers and their staffs on Capitol Hill during the ACR’s annual Advocates for Arthritis event, bringing rheumatology professionals and patients together to make their voices heard in the halls of Congress. The meetings this year focused on workforce shortages in rheumatology and on limiting the effects of step therapy, whereby insurers may not approve a doctor-prescribed therapy until the patient has tried a drug preferred by the insurance company, even if the doctor believes the insurer-preferred treatment will not be effective for the patient.

Twenty-two rheumatology fellows also took part in the ACR’s Advocacy 101 program. The course is designed to educate trainees about legislative and regulatory healthcare policies impacting rheumatology and about the challenges of the changing healthcare system that they will face in their careers and practices. The program also engages fellows in health policy and advocacy endeavors.

“I think the issues struck a chord for all of our advocates,” says Angus Worthing, MD, FACR, FACP, a D.C.-based rheumatologist and chair of the ACR’s Government Affairs Committee (GAC). “We are essentially trying to reduce wait times for people to get into a doctor’s office and to get on the medications they need by bolstering the workforce and working on step therapy.”

Advocates also pressed legislators on drug costs. Dr. Worthing says, “Congress and the Trump administration are facing well-deserved pressure from the American public to reduce drug prices and the cost to patients, so the timing was great for us to tell them what the rheumatology community cares about.”

“Meeting with representatives is a great way to exercise our First Amendment rights and feel like we are doing something,” says Ethan Craig, MD, MHS, a rheumatologist at Penn Medicine and GAC member.

Congressional Education
Laura Ballenger, MD, a third-year pediatric rheumatology fellow at Nationwide Children’s Hospital in Columbus, Ohio, returned to Advocates for Arthritis after taking part in Advocacy 101 last year.

“The biggest thing that brought me back is advocacy is really based on educating people and that’s one part of the medical world I really enjoy,” Dr. Ballenger says. “I met with some people again who I met with last year, and it’s exciting to continue the conversation.”