Members of the WRA are also concerned about a new insurance policy that requires rheumatologists to prescribe the biosimilar Inflectra (infliximab-dyyb) rather than the reference drug Remicade (infliximab), forcing patients who have been stable on one drug to be switched to another.
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“I have no problem starting a biosimilar in a new patient, but changing a stable patient from Remicade to a biosimilar is not good medicine and can result in a disease flare,” Dr. Peterson says. “We’ve written to the Washington Attorney General and the Coalition of State Rheumatology Organizations to appeal this decision.”
Another ongoing issue for the WRA is making prescription medications more affordable for patients. One obstacle: insurance copay accumulator adjustment programs (CAAPs) that require patients to pay a high out-of-pocket cost for prescriptions before their deductible is met. A 2020 ruling from the Centers for Medicare and Medicaid Services allows insurers to implement these programs without restriction.
“These programs extend the amount of time it takes a patient to meet their deductible and reverse the impact of manufacturer cost-sharing assistance for prescription drugs,” says Dr. Peterson. “Recently, several states have passed legislation to prohibit the use of CAAPs.” Members of the WRA are advocating for similar legislation.
Looking to the Future
WRA will hold its annual conference Sept. 16–18 at the Sleeping Lady Mountain Resort in Leavenworth, Wash.
“We have one day devoted to advocacy and one to science,” Dr. Peterson says. “We try to make the conference both fun and informative, and we encourage fellows to attend the conference free of charge.”
This year’s conference marks the 15th for WRA, and Dr. Peterson says the alliance hopes to continue growing its membership. The alliance currently has 35 members, including nurse practitioners. All rheumatologists and rheumatology professionals are welcome to attend the annual conference.
Linda Childers is a health writer located in the San Francisco Bay Area.
- Battafarano DF, Ditmyer M, Bolster MB, et al. 2015 American College of Rheumatology workforce study: Supply and demand projections of adult rheumatology workforce, 2015–2030. Arthritis Care Res (Hoboken). 2018 Apr;70(4):617–626.