Simple Tasks recognizes congressional campaigns like Lois Capps for their dedication to helping millions of patients in the U.S.
U.S. Representative Lois Capps (D-Calif.) began her career in health care as a nurse. Before coming to Congress, Rep. Capps spent 20 years as a public health advocate for children and families, and she continues to advocate for better access to health care. In Congress, Rep. Capps founded and serves as co-chair of the House Nursing Caucus and also serves as co-chair of the Congressional Heart and Stroke Coalition, the House Cancer Caucus and the Congressional School Health and Safety Caucus. Capps has helped pass legislation to address the nation’s nursing shortage, curb underage drinking, detect and prevent domestic violence, improve mental health services, bring CPR classes to schools and improve Medicare coverage for patients with Lou Gehrig’s disease.
Representative Capps backs new legislation to help rheumatology patients
H.R. 1600, The Patients’ Access to Treatment Act (PATA), has been introduced in the U.S. House of Representatives by Reps. Lois Capps (D-CA) and David McKinley (R-WV). If enacted, PATA would limit patient cost-sharing requirements for expensive specialty tier drugs and increase access to life saving biologics.
PATA is attracting broad support from both Republicans and Democrats. Rep. David McKinley (R-W.Va.) is the lead Republican sponsor, and 96 bipartisan lawmakers have cosponsored PATA thus far.
A coalition of physician and patient organizations who constituencies are concerned with high cost-sharing has formed to support the bill. Thus far, more than 24 groups are supporting PATA including the American Academy of Neurology, American Autoimmune Related Disease Association, American College of Rheumatology, American Society of Clinical Oncology, Arthritis Foundation, Colon Cancer Alliance, Crohn’s and Colitis Foundation of America, Hemophilia Federation of America, Immune Deficiency Foundation, Lupus Foundation of America, National MS Society, National Psoriasis Foundation, Patient Services Inc., and the Spondylitis Association of America.
In 2015, the coalition held a briefing on Capitol Hill to raise awareness about the bill and the growing trend of high patient cost sharing for biologic drugs. Patients and physicians shared personal stories of how excessive out-of-pocket payments associated with specialty tiers – often hundreds or even thousands of dollars per month per medication – are preventing many from receiving necessary medications to treat chronic illnesses and inflammatory diseases.
Christian Smith, who has juvenile idiopathic arthritis, participated in the briefing and shared his story of living with a disease that affects nearly 300,000 children in the United States. At the age of nine, Christian experienced sharp knee pain that traveled to the rest of his body and left him bedridden. Fortunately, Christian found a medication to relieve the pain and wants to make sure that others have access to treatments that prevent disability and allow them to maintain daily function.
More than eleven million Americans suffer from inflammatory rheumatic diseases such as juvenile idiopathic arthritis, gout and lupus. Biologic drugs, which resemble naturally occurring antibodies, have been used to successfully treat many patients with rheumatic diseases who would otherwise become disabled. With rheumatic diseases, early diagnosis and treatment are crucial. Treatment during “the window of opportunity,” which is the first weeks and months after symptom onset, can prevent much of the damage rheumatic diseases can cause. The importance of early treatment makes it imperative that patients not postpone or forgo recommended medication, which they may do if the cost is too great.
When insurance companies move biologic drugs into a “specialty tier”, which often requires patients to pay a percentage of the actual cost of the drugs, access to those drugs can become prohibitively expensive. Because biologic drugs have no inexpensive generic equivalents, placing them in “specialty tiers” with high coinsurance requirements can mean patients are forced to pay hundreds or thousands of dollars each month, or simply go without treatment. PATA would help insured patients afford necessary treatments and reduce disability and rising health care costs associated with rheumatic diseases and other conditions treated with specialty drugs.
“Congresswoman Capps understands the value of biologic drugs,” says Timothy Laing, MD, American College of Rheumatology government affairs chair and rheumatology faculty at the University of Michigan. “PATA will ensure that millions with chronic diseases will have access to therapies that can make a positive change in the course of devastating diseases.”
Congresswoman Capps has pledged to continue advocating for rheumatology professionals and those with rheumatic diseases. To learn more about Capps, visit her website.
The Simple Tasks campaign thanks Congresswoman Capps for her leadership in support of the Patients’ Access to Treatments Act.