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Access to Medication Bills Moving Through Congress

June 28, 2018

Two access to medication bills supported by the National MS Society are advancing through Congress this year. 

Electronic Prior Authorization (H.R. 4841/S. 2908)

Prior authorization is a requirement that your physician gets approval from your health insurance to prescribe a specific medication for you. This traditionally has required payers and providers to do a lot of paperwork and a lot of phone calls and faxes back and forth – physicians on average spend 20 hours per week working through these requests. Because of the burdensome process, millions of prescriptions are abandoned at the pharmacy counter every year—causing non-adherence, disease progression and increased costs to the health system. 

H.R. 4841/S. 2908 would automate many of the communications amongst healthcare providers, payers and pharmacists in Medicare so that consumers can get their prescriptions faster. The bill would rely on electronic prior authorization standards known as the SCRIPT standards which were developed by the National Council for Prescription Drug Programs and are already used by many providers, pharmacists and health plans. The U.S. House of Representatives passed the bill on June 19, 2018 and the U.S. Senate is moving the bill through the Senate Finance Committee. 

Creating and Restoring Equal Access To Equivalent Samples (CREATES) Act of 2017 (H.R. 2212/S. 974)

Pharmaceutical companies who make generic medications need access to samples to conduct drug product development and bioequivalence studies necessary for Food and Drug Administration approval. However, some companies attempt to block generic company access to these samples. The CREATES Act would prohibit brand pharmaceutical manufacturers from using safety programs/restricted access programs as a way to prevent generic or biosimilar manufacturers from purchasing samples to understand how the medication works (and create a generic, lower-cost product). A generic manufacturer could bring a civil action against the brand pharmaceutical company if the brand manufacturer refuses to supply samples. According to the Congressional Budget Office, this bill would save $3.8 billion in federal spending.

The National MS Society asks Congress to pass the Senate version of the CREATES Act, as well as H.R. 4841/S. 2908 this year. 

Learn more about affordable access to MS medications. 

About Multiple Sclerosis

Multiple sclerosis is an unpredictable, often disabling disease of the central nervous system that disrupts the flow of information within the brain, and between the brain and body. Symptoms range from numbness and tingling to blindness and paralysis. The progress, severity and specific symptoms of MS in any one person cannot yet be predicted, but advances in research and treatment are leading to better understanding and moving us closer to a world free of MS. Most people with MS are diagnosed between the ages of 20 and 50, with at least two to three times more women than men being diagnosed with the disease. MS affects more than 2.3 million people worldwide.

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