WASHINGTON, D.C. - The American College of Rheumatology (ACR) today applauded the leadership of Rep. David McKinley (R-WV) and Rep. G.K. Butterfield (D-NC) in reintroducing H.R. 2999, the Patients' Access to Treatment Act (PATA). The bipartisan legislation would limit cost-sharing requirements for medications placed on specialty insurance tiers and make innovative and necessary therapies more accessible to Americans living with rheumatic diseases by reducing excessive out-of-pocket expenses.
"The ACR applauds the reintroduction of the Patients' Access to Treatment Act and the bipartisan effort by Rep. David McKinley and Rep. G.K. Butterfield to make biologic therapies more accessible and affordable for Americans living with rheumatic diseases," said Dr. Angus Worthing, MD, practicing rheumatologist and chair of the ACR's Government Affairs Committee. "It is a travesty that even with health insurance, Americans are finding it increasingly difficult to afford the therapies prescribed by their doctors to help them manage their disease, avoid permanent disability, and lead active, full lives. No one living with a chronic disease should have to choose between their physical and financial health. We implore Congressional leaders to enact PATA this session and in doing so, take an important step toward ensuring all Americans can access necessary and life-changing drugs."
Nearly 20 percent of employer health insurance programs and 85 percent of Medicare plans now place the most expensive and innovative drugs on so-called "specialty tiers" that require patients to pay a percentage of the actual cost of the drugs, rather than a fixed co-pay amount each month. According to a 2015 Pew Charitable Trusts report, the number of Americans with annual drugs costs greater than $50,000 increased 63 percent in 2014, with 92 percent of those patients using high-priced specialty drugs. The same report found that some health plans charge a co-insurance payment as high as 33 percent.
With the average annual price of biologic therapies ranging from $15,600 to $36,000, patients who are prescribed biologics on specialty tiers must pay hundreds or thousands of dollars in copayments each month or go without treatment due to prohibitive costs. PATA would make specialty drugs more affordable by limiting cost-sharing requirements, thereby improving patient access to life-saving drugs, reducing disability and stemming the rising healthcare costs associated with rheumatic diseases.
More than 11 million Americans suffer from inflammatory rheumatic diseases such as rheumatoid arthritis, juvenile idiopathic arthritis, gout and lupus. Biologic drugs have been used to successfully treat many patients living with these painful and debilitating diseases.
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About the American College of Rheumatology
The American College of Rheumatology (ACR) is the nation's leading advocacy organization for the rheumatology care community, representing more than 9,500 rheumatologists and rheumatology health professionals. As an ethically driven, professional membership organization committed to improving healthcare for Americans living with rheumatic diseases, the ACR advocates for high-quality, high-value policies and reforms that will ensure safe, effective, affordable and accessible rheumatology care.