Rheumatology Champions Call for Lower Prescription Drug Costs, and More in Meeting with Congressional Legislators

ACR advocates recently returned to Capitol Hill to meet with members of Congress as part of the Advocates for Arthritis fly-in conference on Sept. 26. This annual event brings together rheumatology professionals to advocate on behalf of the rheumatology community. Core issues on which the advocates focused this year include lowering the out-of-pocket cost of prescription drugs, the repeal of arbitrary Medicare therapy caps and to shed light on the role of pharmacy benefit managers in drug pricing.

Help Strengthen the ACR’s Voice in Washington, D.C.

It will take the voice of all rheumatology professionals and patients to get Congress to act. Write, call or email your legislators. As a constituent, your members of Congress are elected to represent you. Ask them to support these priorities:

Reduce Patients’ Out-of-Pocket Expenses

• House: Cosponsor H.R. 2999, the Patients’ Access to Treatments Act, to limit patients’ cost-sharing requirements for specialty tier drugs and increase access to lifesaving biologics.
• Senate: Introduce the Patients’ Access to Treatment Act (PATA) in the Senate; Request a Senate hearing on the use of specialty-tier drug pricing.

Repeal Medicare Therapy Caps

• House: Cosponsor H.R. 807, the Medicare Access to Rehabilitation Services Act, legislation that would repeal the cap on outpatient rehabilitation services.
• Senate: Cosponsor S. 253, the Medicare Access to Rehabilitation Services Act.

Expose Pharmacy Benefit Managers’ Role in Prescription Drug Pricing

• PBMs can drive up drug costs by creating market pressure for higher list prices (the higher the list price, the higher the rebate).
• PBMs use their position to negotiate contracts with manufacturers, insurers and pharmacies that maximize their profits, often at the expense of patients.
• PBMs use spread pricing in which they charge an insurer a different amount for given drugs than what it reimburses the pharmacy for dispensing the drugs. This may be kept as extra profit by the PBM.
• PBMs use drug-switching practices, which increase profits by steering patients toward expensive medications whose manufacturers pay rebates to PBMs for promoting a particular drug.

Be an Effective Advocate When Members of Congress Are at Home

• Invite your legislators to your office. This is a great opportunity to educate members of Congress on the importance of the rheumatology subspecialty and the effect that arthritis and rheumatic conditions have on quality of life.
• Meet with your legislators in their district office. An in-person meeting is an effective way to convey your message and allows you to build relationships with your legislators.
• Volunteer for a campaign. Volunteering is a great way to get involved in the political process. Support the candidate who will best represent the rheumatology community.

We must stay united to effect change. Contact your elected officials and make your voice heard. To find your legislators’ contact information or for more information on ACR advocacy activities, contact [email protected], or visit www.rheumatology.org/advocacy.