Concerns about how the Trump administration’s ideas to lower drug prices could reduce patient access to medicines led the ACR to speak out on many different fronts.
On June 25, at a briefing hosted by the ACR and the National Psoriasis Foundation (NPF), a packed room of Congressional staffers and reporters learned from rheumatologists and patients about the challenges involved when patients transition to Medicare. The briefing also addressed how the treatment of chronic conditions, such as arthritis, is being negatively impacted by current drug pricing that could worsen if proposed price changes are enacted, explains Angus Worthing, MD, FACR, FACP, chair of the ACR’s Government Affairs Committee.
Drug Pricing & Treatment Access
“The ways the U.S. drug pricing and drug distribution systems affect our patients are quite complex, and I think we were able to raise awareness on Capitol Hill about how to distinguish between the kinds of reforms that can improve our patients’ access to medicines and those that can worsen access,” Dr. Worthing says.
At the briefing, Dr. Worthing spoke about what a rheumatologist is and how important it is to protect access to breakthrough treatments that have revolutionized rheumatology care, and continue to prevent disability and early death for patients. “I answered questions about the Trump administration’s plans to move Part B drugs into the Part D system, and some of the barriers to the uptake of biosimilars as a way of lowering drug prices.”
Colin Edgerton, MD, FACP, RhMSUS, chair of the ACR’s Committee on Rheumatologic Care (CORC), also spoke at the briefing, and hopes this latest discussion and other dialogue the ACR is leading will help legislators realize the difficulties patients have in accessing treatment. The hope is that these decision makers will incorporate this information into current discussions on medication pricing, such as preserving the Part B program as is, and not following the administration’s plans to transition all or part of the Part B benefit into a system that looks more like Part D.
“The Medicare Part D benefit uses utilization management, such as formularies, fail-first policies, step therapy, prior authorization and cost-tiering, [which] makes it difficult for patients to access biologic medicines for treatment of conditions, such as psoriatic arthritis and rheumatoid arthritis. In contrast, the Medicare Part B benefit does an excellent job of maintaining patient access to these therapies with minimal hassle,” Dr. Edgerton explains.
“It would be a shame for the administration to use these tools to reduce drug prices by reducing access to critical treatments,” Dr. Worthing adds.
