“After considerable advocacy on our part and that of a large coalition, the demonstration was not implemented. We do agree that the extremely high costs of biologics need to be addressed, but an essentially nationwide CMMI project was too broad in scope, and a foundational assumption—that there are less expensive, equally effective alternative therapies available for prescribers—was not applicable to rheumatology,” says Dr. Worthing. “We point out the opportunity to lower costs by strengthening the FDA’s ability to approve drugs in the biosimilar pipeline, which will foster competition that can drive down those prices. Meanwhile, the CMMI can be an important component for creating innovative, appropriately scaled projects that help our patients maintain access to treatments and care.”
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The Healthcare Leaders for Accountable Innovation in Medicare has created a website to provide updated information about these advocacy efforts. Also visit the ACR’s website for specific updates.
Susan Bernstein is a freelance medical journalist based in Atlanta.