Prong 1: Support safe, effective biosimilars to compete with reference biologics. For the prices of biologics to drop, biosimilars must be approved, and for that to happen the FDA needs stable funding and innovative ways to hire approval experts quickly. Enter Scott Gottlieb, MD, who was just confirmed as the FDA commissioner. He is on record as wanting to speed up drug approvals. As long as the FDA continues to prioritize safety and efficacy, this may bode well for reducing biologics prices.
Prong 2: Increase transparency of the pricing schemes between pharmacy benefit managers (PBMs), manufacturers and insurers. The ACR is teaming up with CSRO and other organizations in a coalition to expose the secrecy and conflicts of interest in the PBM pricing system. This is gaining bipartisan traction on the Hill as lawmakers are becoming interested in transparency for patients and employers whose insurance premiums are increasing.
There is some room for optimism in our two-pronged approach to lowering drug prices via biosimilars and drug price transparency. The ACR recently praised lawmakers for creating momentum on our issues.
May Hill Visit
Next month, ACR leaders will be on the Hill advocating to advance multiple issues. We will press for increased NIH research funding and also for creation of a new arthritis research program to be housed at the Department of Defense. Sen. Alexander (R-TN), powerful chair of the Senate’s committee on health, says Congress would raise, not lower NIH research funding despite President Trump’s suggested cuts. We will also support ways to improve the projected rheumatology workforce shortage, including the H-1B visa issue above, as well as increasing GME slots and funding. Finally, we will ask Congress to repeal IPAB—the unelected group of officials who could have power to cut physician reimbursement without full Congressional oversight.
Good News from the Local D.C. City Council
Your ACR state advocacy team shepherded a copay cap through the D.C. City Council last year. Then, as per the Constitution, Congress reviewed our bill—and thankfully, it was cleared Apr. 14. Now, D.C. becomes the third state or territory to limit specialty drug copayments to $150 a month. No more thousand-dollar coinsurances.
I encourage you to get involved in your state rheumatology society and share your views with your legislators. You, too, can make a law. For example, 26 states have biosimilar bills on the books—mainly to ensure that prescribers would be informed of a substitution —and you can easily get involved in this and other important initiatives at the ACR.