ACR on the Hill: Members Ask Congress to Reduce Barriers to Care

Last month, 80 rheumatologists, rheumatology professionals and patients living with rheumatic disease convened in Washington, D.C., for the ACR’s annual Advocates for Arthritis Conference, where they marshaled in support of legislation that would reduce current barriers to care for patients by taking steps toward mitigating the impact of pharmacy benefit managers (PBMs) on rising prescription drug costs and codifying exceptions to step therapy policies in private insurance.

On Sept. 27, attendees connected with the offices of more than 110 members of Congress to support:

• Legislation increasing transparency and limiting the impact of PBMs on rising drug costs. PBMs act as intermediaries between insurers, drug manufacturers and pharmacies by setting copayment amounts and determining which drugs are covered by which insurers. PBMs profit at the expense of patients by negotiating discounts and rebates from manufacturers in exchange for the preferred placement of the manufacturer’s drug on an insurer’s formulary. Relevant legislative language includes S. 1339, S. 127, H.R 4822 and H.R 2679; and
• Including The Safe Step Act of 2023 (H.R 2630/S. 652) language in any healthcare package. This legislation creates a clear and transparent process for patients with employer-sponsored insurance to seek exceptions to step therapy, establishes a reasonable and clear timeframe for override decisions and requires insurers to consider the patient’s medical history and the provider’s expertise in partnership before denying a patient medically necessary treatment.

See this and other tweets from Hill Day participants at https://twitter.com/hashtag/Act4Arthritis.

Now it’s your turn: Amplify attendees’ efforts by sending letters to your members of Congress in the Legislative Action Center. It takes only a few minutes to do your part!

You can also see more of your colleagues’ experiences on X with the hashtag #Act4Arthritis.