“The greatest challenges our members currently face concerning biosimilars include the economic challenges of underwater biosimilars and the myriad adalimumab biosimilars and varying insurer mandates and prior authorization requirements on the pharmacy side,” Dr. Phillips shares. “Because commercial and MA payers increasingly have chosen one or two versions of each bio-originator they will allow, this frequently leads to forced switches from one version to another of a given drug.” He will discuss approaches to these mandates, including best practices for interacting with payers and patients, and will review ACR advocacy on these topics.
The RA Toolkit
For patients with complex disease requiring advanced treatments, payers are frequently looking for outcomes data or measures of disease activity, Dr. Niemer says. Often, data embedded in a patient’s medical record can help expedite this process on many fronts.
Dr. Yazdany
To help practices meet these data requirements and streamline workflow for high-quality care with fewer disruptions, the ACR launched the RA Measures Toolkit in 2023. The toolkit’s lead creator, Jinoos Yazdany, MD, MPH, professor of medicine at University of California San Francisco and chief of rheumatology at San Francisco General Hospital, will present ways the toolkit can help optimize patient care.
“Insights we gathered from the RISE registry revealed a fascinating trend—some practices were consistently performing at a high level,” Dr. Yazdany says. “This curiosity sparked the development of the toolkit through extensive interviews with dozens of individuals from practices across the country, uncovering both their innovations and the barriers they faced.”
One pain point she will discuss is the challenge of continually training staff when there is a high rate of staff turnover. To ease this burden, the toolkit includes dedicated training materials for nursing and support staff to make onboarding smoother and more consistent. She’ll also discuss patient-reported outcome forms created in several languages to make data collection easier for all patients.
