On Thursday, November 2, the Centers for Medicare and Medicaid Services (CMS) announced they would reverse a policy determining how providers are paid for administering biosimilar drugs under Medicare Part B. A biosimilar is a type of medication that is “similar” to a biologic reference product, approved by the Food and Drug Administration (FDA); biosimilars offer patients the promise of more affordable treatment options available on the market to address their disease.
Over the past twenty-four months, the Arthritis Foundation and other patient organizations have expressed our collective concerns with CMS’s biosimilars reimbursement policy and encouraged them to reverse it. This policy reversal is a crucial access to care victory for the arthritis community since there are two biosimilars on the market to treat arthritis. The regulatory change will foster competition and lower the cost of expensive biologic treatments, while encouraging innovation of new therapies – ultimately creating a robust marketplace of biosimilars. Read on to learn more about this important win for patients.
Continue reading Arthritis Foundation Plays a Role in CMS Biosimilars Policy Reversal
On behalf of the more than 3.6 million New Yorkers (including 18,400 children) with doctor-diagnosed arthritis, the Arthritis Foundation thanks Governor Andrew Cuomo for signing biosimilar legislation into law. The new law, A.7509/S.4788, enhances patient access to new and innovative medications while ensuring that pharmacists are communicating critical and up-to-date medical information about patients to physicians.
Continue reading Victory in New York! Biosimilar Legislation Signed Into Law
On Thursday, October 12, 2017, the Administration took two actions on health care that could affect coverage for people who have health insurance through the exchanges.
President Trump signed an executive order that opens the door for the expansion of association health plans, which aren’t subject to the same level of patient protections as required by the Affordable Care Act (ACA). Second, the Administration announced the discontinuation of cost-sharing reduction payments, which are payments to health insurers that help reduce out-of-pocket costs for low income people who purchase insurance on the health exchanges.
Read on to learn more about the Administration’s actions and their potential impacts on the arthritis community.
Continue reading Answering Your Questions About the Latest Administration Actions on Health Care
From Ethan Berkovitz
My name is Ethan Berkovitz, I am a 16-year-old high school sophomore and my favorite sports are soccer and futsal, a type of indoor soccer with five players per team. I play on the U.S. Youth Futsal 16-and-under National Team, and this summer I got to compete and represent our country in Costa Rica. I have been playing soccer since I was 3 years old – and I have juvenile arthritis.
I didn’t always have juvenile arthritis. It all started when I was 8 years old, when I started having pain in my legs, hands and wrists. I thought I was having growing pains, but it got worse and worse in just a few short months. I couldn’t even walk down the stairs, or to the bus stop, so my dad had to carry me. Sometimes, I didn’t make it to school because I didn’t feel very well and I would get fevers, so I felt really sick. I loved playing all kinds of sports back then with my friends and I was on lots of different teams. I also would ride my bike, skateboard, rollerblade and much more.
Continue reading Junior Ambassador Spotlight – Ethan Berkovitz, Ohio
The Senate is expected to open debate today on two bills that repeal and replace the Affordable Care Act. Tell your senator to vote no and work to write a health bill that serves patients!
Not getting health insurance because you have a pre-existing condition.
Thousands upon thousands of dollars in out-of-pocket costs every year with no end in sight.
Fear of reaching your maximum lifetime benefit because you take expensive drugs or had multiple surgeries and hospital stays.
This is what life looked like for many people before the Affordable Care Act (ACA) was passed into law in 2010. While the ACA is far from perfect, it offers critical protections like caps on annual out-of-pocket spending, a ban on lifetime coverage limits, a prohibition on pre-existing conditions exclusions and minimum essential health benefits like prescription drugs and hospitalizations.
Continue reading Senate Health Bills Fall Short for Arthritis Community
From Kerry Wong
Nearly 10 years ago, I began feeling a variety of symptoms that didn’t seem to make much sense. I was exhausted and sore without doing anything strenuous, frequently weak, dizzy and nauseous. I couldn’t sleep.
Continue reading Ambassador Spotlight: Kerry Wong, New York
Our Advocates have been busy. Very busy. And the results are fantastic!
Due in part to tireless work by our volunteer Advocates, 9 states passed legislation within the first six months of 2017 to address issues with biosimilar medications.
Continue reading Nine Major Wins in 6 Months!
On June 2, Colorado Governor John Hickenlooper signed Senate Bill 203 (SB 203) into law! This important bill stops insurance plans from requiring patients to go through step therapy for their medication if they previously went through step therapy protocols with their current or former insurer.
Continue reading Colorado Passes Law Restricting Step Therapy!
Exciting news in Texas! On May 23, Governor Greg Abbott signed Senate Bill 680 into law, limiting the use of step therapy. Texas now joins a growing number of states that have enacted laws that regulate the use of step therapy. With over 4 million adults and 24,900 kids with doctor-diagnosed arthritis in Texas, this is a major victory!
Step therapy is used by health insurance providers to control the order and use of prescriptions drugs. A patient could be required to try and fail lower-cost or other drugs selected by their insurance provider before coverage is granted for the drug prescribed by the patient’s treating physician. For patients, this barrier to care prevents timely access to doctor prescribed treatments and can be the difference between full mobility and joint damage.
Continue reading Victory in Texas – Legislation Limits Step Therapy
We applaud Maryland Governor Larry Hogan for joining 28 other states in creating a pathway for the substitution of biologic medications with biosimilars by signing the Pharmacists – Substitution and Dispensing of Biological Products bill into law.
Biologics are life altering drugs for people with arthritis and are very complex products made with living cells. Because of this complexity they are expensive. Biosimilars, are a new class of drugs that are similar to biologics. They have the potential to lower medication costs.
Continue reading Victory for Maryland! Biosimilar Bill Signed by the Governor!