The ACR continues to advocate against the addition of Stelara to the Medicare Self-Administered Drugs (SAD) list. Most recently, the ACR partnered with the Coalition of State Rheumatology Organizations and the Arthritis Foundation to send a letter to the Centers for Medicare & Medicaid Services requesting that it review the Medicare Administrative Contractors’ (MACs) decision to add this drug to the SAD list. Keeping Stelara off the list is important to ensure continued access for patients who can’t self-administer.
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Earlier this year, most of the MACs announced plans to move Stelara to the SAD list. However, this change was delayed as a result of the COVID-19 global pandemic. Implementation is now planned for 45 days after the end of the public health emergency. Moving Stelara to the SAD list would effectively shift coverage to Medicare Part D, prohibiting patient access under Part B.
The ACR remains concerned about the appropriateness of moving this drug to the SAD list and the impact of this decision on patient access. Doing so would leave vulnerable patients with limited treatment options. ACR advocacy efforts will continue to prioritize protecting patient access to Stelara under Medicare Part B.
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