Greetings, Patient Advocates!

2019 is here and with it a new Congress begins. As always, the American College of Rheumatology will be advocating for policies that improve care access and quality for Americans living with rheumatic disease. Specifically, there are three major legislative initiatives which we believe the 116th Congress must address. You can help us put these issues on lawmakers’ radars by sending a letter to your Members of Congress today.

Step Therapy

Step therapy is an unfortunate insurer practice that requires patients to try an insurer-preferred therapy before covering the therapy recommended by the patient’s doctor – even if doctors doubt the “preferred” treatment will be effective. This undermines the clinical expertise of care providers by allowing insurance companies to make crucial treatment decisions for patients. In 2019, it is our mission to protect patients from insurer’s overzealous use of step therapy by passing legislation to improve safeguards and expedite the approval for step therapy exceptions.

Funding for Arthritis Research

We are asking Congress to allocate existing funds to create a $20 million Congressionally Designated Medical Research Program for arthritis research within the Department of Defense. Medical research initiatives overseen by the Pentagon have already made great progress in furthering our understanding of conditions such as kidney disease, epilepsy, PTSD, and a host of other ailments which disproportionately affect service members and their families. Arthritis is one of the leading causes of discharge for U.S. military personnel and affects one in four military veterans. Since the Department of Defense has already been directed by Congress to invest resources into the study of rheumatic diseases such as arthritis in 2019, all we need to do is apply enough pressure to ensure that this research receives the time and money that it desperately needs.

Drug Pricing

It is estimated that the prices of around 285 different medications have risen since January 1, 2019 – a shocking statistic that is only expected to get worse throughout the year. This troubling trend will put political pressure on the White House and Congress to take action to address the skyrocketing price of prescription drugs. A good first step to address this problem would be to increase oversight over Pharmacy Benefit Managers (PBMs) and support legislation to limit insurers use of specialty tiers, which saddle patients with thousands of dollars in out-of-pocket costs related to their medication.

Our agenda will require persistent and enthusiastic involvement from patients like you advocating for change. Join the fight by sending a letter to your Members of Congress today and asking for their help to improve care for the 54 million Americans who currently suffer from rheumatic disease or share your story with us to help our overall advocacy efforts.

Dr. Angus Worthing