Scratch that. We can do more than hope. We can also act, by supporting advocacy by direct action or through investment in RheumPAC. Unbeknownst to many of us, the Government Affairs Committee and the Committee on Rheumatologic Care have advocated on our behalf for legislation to deter step therapy, mandatory drug switching, onerous prior authorizations and tiering of medications. These efforts will eventually benefit all of us, patients and physicians alike.
Until then, we need to remind our patients to vote with their pocketbooks. Most of our patients are unaware of the uncounted minutes we spend to ensure they can receive the drugs they need. They don’t know because we do not tell them, because it seems unseemly to complain.
Many patients will have no choice in their insurance carrier, and for them, we will do what we must. Others may be able to speak to their employers about how their current options are failing them; I have had patients who have convinced their employers to drop or add carriers to address their need for medical insurance that will support patients who need more than just the occasional visit for the common cold. Otherwise, most patients who receive medical insurance through their employers will have an annual opportunity, typically during autumn, to change their carriers. We should remind our patients to take advantage of these opportunities to ensure that their coverage matches their needs.13 Their lives may depend on it.
Philip Seo, MD, MHS, is an associate professor of medicine at the Johns Hopkins University School of Medicine, Baltimore. He is director of both the Johns Hopkins Vasculitis Center and the Johns Hopkins Rheumatology Fellowship Program.
References
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- MacKenzie CR, Meltzer M, Kitsis EA, Mancuso CA. Ethical challenges in rheumatology: A survey of the American College of Rheumatology membership. Arthritis Rheum. 2013 Oct;65(10):2524–2532.
- Patients have no more skin to give: Dr. William Harvey testifies on rheumatology issues before Senate Committee. The Rheumatologist. 2018 Feb 16.
- Harvey WF. Testimony before the Senate Special Committee on Aging. 2018 Feb 7.
- Department of Health and Human Services. Promoting healthcare choice and competition across the United States: Request for information. 2018 Jan.
- American College of Rheumatology. ASPE-Healthcare Choice RFI. 2018 Jan 25.
- Drash W. CNN exclusive: California launches investigation following stunning admission by Aetna medical director. CNN. 2018 Feb 11.
- Drash W. Aetna inquiry widens over ex-medical director’s comments. CNN. 2018 Feb 16.
- Nowogrodzki A. How can the U.S. catch up on biosimilars? MedCity News. 2018 Feb 16.
- Mortimer R, White A, Frois C. Will ‘biosimilar’ medications reduce the cost of biologic drugs? Not necessarily. Scientific American. 2017 Mar 9 .
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- Mulcahy AW, Hlavka JP, Case SR. Biosimilar cost savings in the United States: Initial experience and future potential. Rand Corporation. 2018 Feb 19.
- Make sure you’re covered for your biologic medicine! Creaky Joints. [n.d.]
