Read all about what is happening with CSRO. To view our Bi-Weekly Updates, click here. To view the latest editions of Rheum for Action, click here.
posted: December 12, 2024 to CSRO News
Families across the commonwealth need solutions that will meaningfully lower their health care costs. As a pediatric rheumatologist, I’ve witnessed families making hard choices when their prescriptions become too expensive.
posted: September 29, 2024 to CSRO News
Local pharmacies in Kansas face challenges that are reducing their profits and, in some cases, forcing them to close completely.
posted: September 18, 2024 to CSRO News
As a rheumatologist, I am dedicated to improving the lives of patients suffering from chronic autoimmune diseases like rheumatoid arthritis, lupus, and psoriatic arthritis. These conditions, often crippling, necessitate prompt and productive treatments to manage symptoms and avert irreversible joint damage and other long-term complications of uncontrolled inflammation.
posted: August 14, 2024 to CSRO News
Rising consolidation among pharmacy benefit managers (PBMs) allows the companies to profit at the expense of patients and independent pharmacists. That's the conclusion of a recent Federal Trade Commission (FTC) report on interim findings from the agency's ongoing investigation of PBMs.
posted: August 7, 2024 to CSRO News
As the Federal Trade Commission (FTC) and Congress turn their attentionopens in a new tab or window to the business practices of pharmacy benefit managers (PBMs), companies are springing up to provide alternative ways for employers to manage their drug benefits.
posted: July 23, 2024 to CSRO News
CSRO joined the Community Oncology Alliance (COA), The Food Industry Association (FMI), the National Association of Chain Drug Stores (NACDS), and the National Community Pharmacists Association (NCPA) in sponsoring an ad that went into the Wall Street Journal to coincide with the PBM executives testifying before the House Committee on Oversight and Accountability hearing on July 23.
posted: May 14, 2024 to CSRO News
CSRO continues to receive reports from practices nationwide about the financial challenges posed by certain biosimilars for which acquisition costs exceed reimbursement levels. This problem was first noted with Inflectra® (infliximab-dyyb), a biosimilar for Remicade®, but has now extended to Avsola® (infliximab-axxq), another Remicade® biosimilar, as well as several Rituxan® (rituximab)biosimilars.
posted: May 2, 2024 to CSRO News
CSRO Vice President of Advocacy & Government Affairs Dr. Madelaine Feldman joined nine other co-authors in a white paper explaining the unintended consequences of alternative funding programs, and this HR.com article highlights some of those key takeaways.
posted: April 23, 2024 to CSRO News
Nearly 75% of adults in Missouri live with at least one chronic condition, which can often have a significant impact on their lives. As a rheumatologist in Kansas City, I’ve seen firsthand the toll that chronic conditions such as arthritis can have on my patients.
posted: April 3, 2024 to CSRO News
Across the country, a number of state legislatures have considered enacting prescription drug affordability boards (PDABs). While the intention might be to lower costs, the implementation of these price control boards has adverse effects on patients’ access to medicines they depend on, especially to manage rare and chronic conditions.
posted: April 2, 2024 to CSRO News
Mississippi ranks dead last in health outcomes out of all 50 U.S. states. As a longtime advocate for access to rheumatology care and a physician, I am seriously concerned about this trend especially since more than 27% of adults in Mississippi live with arthritis, a condition treated by rheumatologists.
posted: April 1, 2024 to CSRO News
Governor Youngkin must make a decision very soon whether to sign into law SB 274, the General Assembly’s bill creating a state-run Prescription Drug Affordability Board (PDAB). Once in place, this board would have the power to set upper list price limits on pharmaceuticals bought and sold within the commonwealth, but not what patients actually pay.
posted: February 20, 2024 to CSRO News
CSRO Vice President of Advocacy & Government Affairs Dr. Madelaine Feldman joins nine other co-authors in this white paper that explains the unintended consequences of alternative funding programs, raises attention to the risks for employers and employees, and provides more ethical cost-containment strategies for employer-sponsored health plans.
posted: February 20, 2024 to CSRO News
The Winter edition of CSRO's bi-annual Policy Update is now available and features exclusive updates on our state and federal advocacy activity.
posted: February 14, 2024 to CSRO News
Congress is in the process of negotiating a set of bipartisan health policies, including pharmacy benefit manager (PBM) reform. On the table for inclusion are two policies that will provide immediate relief for patients in the form of reduced out-of-pocket costs for drugs.
posted: January 24, 2024 to CSRO News
Klobuchar Presses Drugmakers to De-list FTC-Disputed Patents by End of Month; FTC Responds to Motions to Dismiss in Case Against U.S. Anesthesia Partners and Welsh Carson; Updates on Encompass Health, iRythm, Corcept
posted: January 9, 2024 to CSRO News
For years, I’ve watched the barriers my patients face in accessing the treatments I prescribe continue to grow. That is part of the reason I and many other health care professionals and patients advocated vociferously back in 2020 to pass updated legislation in Louisiana that addressed one of the most daunting barriers that can be placed on prescribed treatments — a process called "step therapy."
posted: January 7, 2024 to CSRO News
Pharmacy benefit managers serve as middlemen between pharmacists and insurance plans. They are often controlled by large insurance companies, like Express Scripts, which is owned by Cigna, and are thus capable of pricing small independent pharmacies out of business.
posted: January 5, 2024 to CSRO News
The FDA on Friday approved a plan by the state of Florida to allow direct importation to the state of drugs from Canada, many of which are expected to be at a much lower cost than the same drugs procured in the U.S.
posted: November 10, 2023 to CSRO News
On November 2, CMS released the Calendar Year (CY) 2024 Medicare Physician Fee Schedule Final Rule, announcing a conversion factor of $32.7442 – down 3.37% or $1.15 from the CY 2023 MPFS conversion factor of $33.89.
posted: September 27, 2023 to CSRO News
CSRO continues to hear from practices around the country about biosimilars being “underwater” in terms of acquisition cost versus reimbursement level. Although this issue first emerged with regard to Inflectra, it seems to exist for other biosimilars now as well.
posted: September 1, 2023 to CSRO News
State rheumatology leaders from across the country gathered in Austin, Texas this past weekend for the Coalition of State Rheumatology Organizations (CSRO) Advocacy Conference and 20th Anniversary Celebration. Attendees learned about the latest advocacy issues of impact to the rheumatology community.
posted: August 3, 2023 to CSRO News
"Helping North Carolinians navigate the complexities of our health care system is a significant part of my career as a physician – and as the parent of a child with a chronic illness, it’s also a very personal daily battle" - hear more from CSRO Board Member Dr. Firas Kassab.
posted: August 3, 2023 to CSRO News
The Summer edition of CSRO's bi-annual Policy Update is now available and features exclusive updates on our state and federal advocacy activity.
posted: July 24, 2023 to CSRO News
The hotly debated topic of interchangeability between biologics and biosimilars has officially leapt from the hypothetical realm to clinical practice, ushering in a new era of therapy switching in rheumatology.
posted: June 20, 2023 to CSRO News
An influential panel proposed capping Medicare Part B pay for some drugs, arguing this would remove financial incentives to use more costly medicines when there are less expensive equivalents.
posted: June 15, 2023 to CSRO News
Movies and TV programs showing insurance companies denying care to critically ill patients to save money are thought to be episodic in nature — exceptions rather than the rule.
posted: June 12, 2023 to CSRO News
Benefit managers insist they are lowering costs and improving outcomes, but critics say these ‘middlemen’ have too much control.
posted: June 1, 2023 to CSRO News
In a bold move, Coherus BioSciences plans to sell a biosimilar version of Humira — one of the world’s best-selling medicines — at a steep discount, and will work with Mark Cuban’s generic drug company to make the medicine available directly to consumers for even less.
posted: May 2, 2023 to CSRO News
CSRO's Vice President of Advocacy and Government Affairs discusses improving access and healthy equity in Louisiana.
posted: April 24, 2023 to CSRO News
Leaders of the U.S. Senate Finance Committee have introduced a bipartisan framework aimed at regulating pharmacy benefit managers as well as to “modernize and enhance” federal prescription drug programs, according to a press release.
posted: March 17, 2023 to CSRO News
Medscape's highlight of CSRO's 2023 Fellows Conference: Various career paths open to newly board-certified rheumatologists — and some of the pros and cons for each — were explored at the recent 2023 Fellows Conference of the Coalition for State Rheumatology Organizations (CSRO).
posted: March 17, 2023 to CSRO News
Medscape's highlight of CSRO's 2023 Fellows Conference: New rheumatologists face a wide range of significant challenges brought on by the increasing complexity of insurance billing and rapid changes to managed care practices, especially techniques of utilization management and pharmacy benefit managers (PBMs).
posted: February 10, 2023 to CSRO News
The Winter edition of CSRO's bi-annual Policy Update is now available and features exclusive updates on our state and federal advocacy activity.
posted: February 2, 2023 to CSRO News
The recent acquisition of Horizon Therapeutics by Amgen continues a trend in medical finance that may have implications for both rheumatologists and their patients.
posted: January 29, 2023 to CSRO News
CSRO Board Member Dr. Michael Brooks shares why Iowa legislators should put an end to non-medical switching.
posted: August 31, 2022 to CSRO News
Changes in Medicare law will help some patients who need costly rheumatology treatments, including several medicines for which competition has been kept in check for many years.
posted: August 30, 2022 to CSRO News
Drug pricing reform has received renewed attention in recent months, but one entity always seems to escape unscathed in reform efforts: pharmacy benefit managers (PBMs).
posted: August 10, 2022 to CSRO News
The Summer edition of CSRO's bi-annual Policy Update is now available and features exclusive updates on our state and federal advocacy activity.
posted: May 19, 2022 to CSRO News
The use of tracking systems -- such as copay accumulators and copay maximizers -- to scrutinize patients' use of drug manufacturer copay assistance programs is causing controversy inside and outside of the federal government, as well as concerns among physicians and patients.
posted: February 24, 2022 to CSRO News
CSRO President Dr. Madelaine Feldman talks with MedPage Today about why pharmacy and provider organizations are disappointed with a decision by the Federal Trade Commission (FTC) not to launch a study into the marketing and financial practices of pharmacy benefit managers (PBMs) -- at least for now.
posted: February 22, 2022 to CSRO News
In the last 4 years, the three biggest pharmacy benefit managers have consolidated influence in the U.S. health care marketplace through vertical integration with insurance carriers.
posted: February 21, 2022 to CSRO News
The Winter edition of CSRO's bi-annual Policy Update is now available and features exclusive updates on our state and federal advocacy activity.
posted: December 17, 2021 to CSRO News
In November, the U.S. House passed the Build Back Better (BBB) legislation, which is now in the Senate, where negotiations are still ongoing.
posted: December 6, 2021 to CSRO News
CSRO President Dr. Madelaine Feldman explains that in the litany of examples of how the U.S. health care system has become so broken, none is as instructive as the 340B Drug Discount Program.
posted: December 2, 2021 to CSRO News
In November, The National Council of Insurance Legislators (NCOIL) hosted their annual meeting, which brought together state legislators from all over the country who are likely to hear bills related to pharmacy benefit managers, utilization management, and other reforms important to the rheumatology community.
posted: November 10, 2021 to CSRO News
The National Conference of State Legislatures (NCSL) hosted their annual meeting, which brought legislators and advocates from across the country together to network and attend educational sessions on policy.
posted: October 26, 2021 to CSRO News
CSRO Board member Dr. Harry Gewanter shares his thoughts on the convoluted issue of drug prices in the Richmond Academy of Medicine's fall newsletter.
posted: September 28, 2021 to CSRO News
CSRO has joined forces with the AIDS Healthcare Foundation, the Community Oncology Alliance, The Food Industry Association, the National Community Pharmacists Association, and the National Federation of Independent Business to establish the Coalition for PBM Reform, which seeks to alter the way pharmacy benefit managers operate to better serve patients, pharmacies and businesses.
posted: September 25, 2021 to CSRO News
CSRO state society member advocates and leadership from around the country gathered virtually in September at the State Society Advocacy Conference (SSAC) to learn about the latest state and federal policy issues impacting the rheumatology community.
posted: September 24, 2021 to CSRO News
In the House, committees of jurisdiction have finished their work on a $3.5 trillion budget reconciliation package, completing one step on what has become a bumpy road to enactment.
posted: July 30, 2021 to CSRO News
The State Access to Innovative Medicines Coalition (SAIM) is the primary organizing vehicle for step-therapy reform and out-of-pocket cost legislation in the states. CSRO has recently transitioned to a new role as the Board’s chair position and is helping to organize and consult on efforts to reform step-therapy and other legislation nation-wide.
posted: July 28, 2021 to CSRO News
On July 27, CSRO leadership from around the country, along with State Society members, virtually assembled to voice their policy concerns with congressional leaders on Capitol Hill.
posted: July 20, 2021 to CSRO News
A new coalition is calling on Virginia legislators to create an oversight board aimed at lowering prescription drug costs and CSRO Board member Dr. Harry Gewanter explains why this is important and how it can help.
posted: July 13, 2021 to CSRO News
While some progress has been made toward ensuring patients receive the discounts offered by manufacturers to save money every single time they buy medicine, more transparency is still needed to stop companies from using rebates to game the system and block the appropriate drugs doctors prescribe.
posted: June 30, 2021 to CSRO News
A new bill in Louisiana prevents payers regulated by the state from mandating the use of white-bagging. Governor John Bell Edwards recently signed SB 191 into law.
posted: June 30, 2021 to CSRO News
When looking at Part B drug spending and potential reform, there is one aspect that has remained unexplored - the physicians office.
posted: June 30, 2021 to CSRO News
The decisions Pharmacy Benefit Managers (PBMs) make often result in vital drugs being unaffordable for many patients.
posted: June 29, 2021 to CSRO News
The Summer edition of CSRO's bi-annual Policy Update is now available and features exclusive updates on our state and federal advocacy activity.
posted: June 15, 2021 to CSRO News
CSRO President Dr. Madelaine Feldman explains that the entire formulary construction paradigm in the U.S. is geared toward one thing - profits.
posted: June 7, 2021 to CSRO News
Momentum in the states to reform the use of accumulator adjustment programs continued as many states wrap up their legislative work for the year - Tennessee and Connecticut became the 9th and 10th states to limit the use of accumulator adjustment programs.
posted: June 7, 2021 to CSRO News
CSRO attended the National Conference of State Legislatures (NCSL) in Puerto Rico at their first in-person executive meeting since the pandemic put a hold on travel.
posted: May 20, 2021 to CSRO News
During the 2019 legislative session in Montana, then Governor Steve Bullock vetoed a bill to place regulations around Pharmacy Benefit Managers (PBMs).
posted: May 12, 2021 to CSRO News
Last month, psoriasis patients covered by Cigna received a curious letter from the insurance giant's pharmacy management division. They could receive a $500 debit card from Cigna, with just one string attached: they would have to switch to a different medication, one preferred by the insurer.
posted: May 12, 2021 to CSRO News
One of the most important areas for reform when looking to reduce drug prices is rebate walls, as shared by CSRO President Dr. Madelaine A. Feldman and Wayne Winegarden in this op-ed for the Pacific Research Institute’s Center for Medical Economics and Innovation.
posted: May 12, 2021 to CSRO News
CSRO Board member Dr. Mark Box joined Patients Rising to have an honest discussion about the clinical side of Lupus.
posted: May 12, 2021 to CSRO News
In a guest piece for the Arkansas Democrat-Gazette, CSRO Treasurer and Arkansas Rheumatology Association president Dr. Michael Saitta shares his thoughts on why step therapy reform is needed.
posted: May 7, 2021 to CSRO News
As prescription drug prices continue to rise, policymakers from across the country are looking for ways to lower costs for patients - this year, West Virginia did more than look.
posted: May 7, 2021 to CSRO News
Arkansas' efforts to protect pharmacies from the predatory and anti-competitive actions of Pharmacy Benefit Managers (PBMs) culminated in the Rutledge v. PCMA case heard in the United States Supreme Court.
posted: April 20, 2021 to CSRO News
On March 25, 2021, Kentucky Governor Andy Beshear signed SB 45 into law, preventing the indiscriminate use of accumulator adjustment programs for state regulated plans in Kentucky and becoming the seventh such accumulator law in the United States.
posted: April 16, 2021 to CSRO News
As a Principal Member of the Alliance for Transparent & Affordable Prescriptions (ATAP), CSRO is sharing their latest member update.
posted: March 30, 2021 to CSRO News
Accumulator adjustment programs are a newly emergent utilization management tool used by PBMs, that have grown increasingly prevalent over the past few years.
posted: March 23, 2021 to CSRO News
On March 13, 2021, the CSRO held its 15th Annual Fellows Conference. The first (and hopefully only) year as a virtual event, this was the first time that it was open to both fellows and practicing rheumatologists, and attendance was at an all-time high.
To view the CSRO news archive, click here.
