Washington Rheumatology Alliance

On December 15, 2020, Genentech led a discussion about how the Most Favored Nations (MFN) model threatens provider and patient access to existing and future medicines; we share your concerns that this could have a detrimental impact on your practice and ability to treat patients. Genentech agrees that we have to work together across the healthcare delivery system to enable all Americans to receive appropriate and affordable care. As we do this, we must protect and sustain patient access to scientific innovation in the U.S. so that people with serious diseases continue to benefit from the breakthrough medicines they depend on. Never has this need been clearer than during the current COVID-19 pandemic.

Below is more information on the MFN model, Genentech’s position, as well as that of other organizations.

• HHS Press Release on MFN interim final rule
• Health Affairs Blog, “Administration Finalizes Most-Favored Nation Drug Pricing Rule At The Last Minute”
• Genentech statement on President Trump’s MFN Executive Order, and Genentech pricing philosophy
• Association statements: PhRMA, BIO, Community Oncology Alliance, American Hospital Association, American Cancer Society – Cancer Action Network

If you would like to independently advocate against this model, I suggest that you reach out to your physician specialty societies and ask them to:

• Engage policymakers, in Congress and in the current and incoming administrations, to stop the implementation of MFN;
• Communicate their concern to CMS via written comments; and
• Consider joining or pursuing litigation challenging implementation of MFN. The most expedient way to get societies involved in existing cases is for them to contact representatives at PhRMA (PHRMA_alliance@phrma.org) or BIO (info@bio.org).

Additionally, you can reach out to your federal and state representatives, to request that they weigh in opposing the model with their peers, and existing and incoming administration officials.

The Arthritis Foundation has free downloadable brochures and fact sheets through the AF Store​ that you can save to your office desktop. The brochures and fact sheets can be e-mailed to patients or you can print copies in-office and hand out to patients as needed. The downloadable materials are a convenient way to provide your patients, who may not be comfortable taking printed materials from your office as a result of the Covid-19 pandemic, the information they are looking for. Instructions are available here.

If you are in need of a bulk order of printed brochures or fact sheets, please contact your local Arthritis Foundation staff member at Washington@arthritis.org for assistance.

The Arthritis Foundation also created a Covid-19 Resources flyer that has a list of great patient resources to help them navigate the pandemic and stay connected.

WASHINGTON, D.C. — A new report from the IQVIA Institute for Human Data Science has determined that biosimilars are on track to reduce drug costs by $100 billion over the next five years if their use rises. The future of this lower-cost drug market, however, is still uncertain.

According to the report, three recently-launched biosimilars may reach 60 percent volume share by the end of their second year on the market, which would generate an estimated $80 billion in savings in the next five years, including $16-36 billion in 2024 alone. Click here to read the full article.

The Biosimilars Forum is a nonprofit organization incorporated in Washington, DC, created to advance biosimilars in the United States with the intent of expanding access and availability of biological medicines, and improving health care. The Biosimilars Forum provides evidence-based information to inform and support public policies that encourage awareness, access, and adoption of biosimilars.

From CreakyJoints:

We’ve been hearing many questions and concerns from our global patient community about the continued spread of coronavirus across the U.S. and around the world.

And while people with disabilities and chronic diseases have even more of a right to feel worried or downright panicked, there is a lack of good information speaking directly to these issues for patients — until now.

CreakyJoints spoke with multiple rheumatologists and infectious disease experts to try to track down answers that are as specific to this community as possible.

Here’s what we have learned so far. We will update you if critical information changes and we will continue to monitor the situation closely. Read the full article.

Get More Tips for Staying Healthy 

• Key Facts About the Flu Vaccine Arthritis Patients Must Know
• What Inflammatory Arthritis Patients Need to Survive Cold and Flu Season
• How Corticosteroids Can Affect Infection Risk

The contents of this website are for informational purposes only and do not constitute medical advice. CreakyJoints.org is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition.

Regence Policy Reversed: The decision from Regence to mandate the switch from Rituxan patients to Ruxience has been reversed and Regence will approve Rituxan patients currently on treatment to continue for 1 year. If you have already submitted the authorization for the patients, then just re-submit their name, DOB and member # via fax to your pharmacy dept. If you haven’t yet submitted an auth, then please submit auth as you normally would.

The pieces that were challenged by Arthritis Northwest Regence’s policy with were:

1. The article (download and keep for your files) clearly stating that biosimilars can be substituted only if approved by FDA as “interchangeable.” In addition, substitution can only be allowed if the prescriber has not designated on the prescription that substitution is prohibited.
2. The concern that my physicians felt regarding “Switching” a stable patient to a non FDA indicated treatment when there are other alternative biosimilars on the market that are indicated for RA.
3. The Washington State Step Therapy Legislation #1879 which clearly outlines the exemption process for immediately granting the request if patient is stable and doing well on treatment.

This is a major “win” in keeping our physicians at the forefront of healthcare. Allowing physicians who are in the position for making the right decision of treatment for the best clinical outcome and accountability for total cost of care, always delivers the best possible patient centered care.