ACR Leads Coalition Response to HHS Proposed Drug Pricing Threats

“We support adherence to the statutory ASP + 6% reimbursement rate for in-office treatments and continue to urge the repeal of sequester cuts to Part B drug reimbursements,” Dr. Huston notes.

4. Introducing physician reimbursement not tied to drugs’ prices could result in further negative effects and limit patient access.

In specialties such as rheumatology that use biologic and other complex therapies, less expensive, yet equally effective, therapies typically don’t exist. Additionally, complex biologics create associated inventory and management costs for the physician. Considering that physicians have no control over the cost of drugs, ancillary services, severity of illnesses and co-morbidities of their patients, physicians should not be penalized for rampant inflation in these sectors.

Taking Action
The ACR and others will be meeting with the HHS to discuss concerns and gather more information about possible plans.

Meanwhile, GAC encourages every ACR member to learn more about how these potential policy changes will negatively impact their patients’ access to rheumatology care, says ACR Government Affairs Committee Chair Angus Worthing, MD.

“We know that our patients’ outcomes depend on early and appropriate treatment by a specialist to control disease activity and prevent or slow disease progression, in addition to preventing costly downstream procedures,” Dr. Worthing stresses. “Drug pricing policy is key to access and outcomes for our patients, and our voice is critically important right now to educate policymakers about this before our patients end up paying the price with their health.”

Carina Stanton is a freelance science journalist in Denver.