Arthritis FoundationArthritis Ambassador Briefing

September 11, 20133PM Eastern

Dial In: 1-866-487-9460Participant Code: 931 709 2991#

Materials available for download at http://www.arthritis.org/ambassador_assignment.php

Agenda• Welcome & August Recap – Laurie Markle, Manager Grassroots

Advocacy• Ambassador Experience– Hanna Gruen (PA-14) • How Limiting Cost Sharing for Specialty Drugs would Impact

Insurance Premiums- Maria Spencer, Director Federal Affairs• September Ambassador Assignment– Laurie Markle• Reporting Your Activity– Laurie Markle• Housekeeping– Laurie Markle• Q&A

1

August Recess Recap

2

August Recess Recap

3

33 Congressional Meetings & Town Halls

Results pending. Email to follow.

Ambassador ExperienceOn the phone:

Hanna Gruen, PA-14 Ambassador

4

HR 460 Impact on Premiums

5

The Problem: Health insurance companies are placing vital, life-changing and life-saving medications including biologics on specialty tiers and charging a co-insurance or percentage of the cost of the drug, instead of a copay.

This practice is placing a substantial financial burden on patients. Some patients may pay hundreds or thousands of dollars per month for a medication that was traditionally on a fixed co-pay.

HR 460 Impact on Premiums

6

The Solution: The Patients’ Access to Treatments Act (H.R. 460): Requires plans to limit cost sharing requirements for specialty drug tiers to the level of cost sharing required for non-preferred brand drug tiers; there can be no more than a 10% difference in total dollar cost sharing for any drugs on a tier.

Drug Type Example Patient Out-of-Pocket Expense

Tier 1: Generic $10

Tier 2: Preferred Brand Name $30

Tier 3: Nonpreferred Brand Name $50 (limits range to 10%: $50-55)

Tier 4: Specialty Tier Drug Cost sharing can be no greater than Tier 3 out of pocket expense.

HR 460 Impact on Premiums

7

Arthritis Foundation and 22 other organizations formed the Coalition for Accessible Treatments (CAT) in support of the Patients’ Access to Treatments Act (H.R. 460)

CAT commissioned a study to address Congressional concerns about PATA’s impact on premiums.

Study Conclusion:Limiting Specialty Drug Coinsurance does not have a large impact on premiums.

The bill would increase premium costs by $3 per year, absent any other changes to the average benefit design.

HR 460 Impact on Premiums

8

What are we doing?

•CAT hosted a press conference to release study results Sept. 10th

•CAT will host a Senate briefing Sept. 19th

•Goal: gain additional co-sponsors in the House; Senate bill introduced

September Ambassador Assignment

9

SUNDAY MONDAY TUESDAY WEDNESDAY

THURSDAY FRIDAY SATURDAY

1 2 3 4 5 6 7

8 9 10 11 12 13 14

15 16 17 18 19 20 21

22 23 24 25 26 27 28

29 30

PRESS EVENT

AMBASSADOR BRIEFING

SENATE BRIEFING

CALLS & EMAILS CALLS & EMALS CALLS & EMAILS

CALLS & EMAILS CALLS & EMALS CALLS & EMAILS CALLS & EMAILS

We need Senate Health Legislative Assistants at the Briefing on September 19th!

September Ambassador Assignment

10

September Assignment: First Steps

11

September Ambassador Assignment

Accessing the resources you need

www.arthritis.org/ambassador_assignment.php

12

13

14

15

Reporting Your ActivityPOSTIVE RSVPs should be reported to Geoff Steber at gsteber@arthritis.org

Report your activity & receive credit at www.arthritis.org/report

• Username: Your email address• Password: Last Name

16

Housekeeping

Remaining Ambassador Briefings:

October 2, 2013 @ 3PM Eastern

November 6, 2013 @ 3PM Eastern

Ambassador Awards are awarded annually based on activity reported October-October. 2013 Award recipients will be announced at the November 6th briefing.

17