Let’s Talk Advocacy – Key Features

When it comes to advocacy Kelly Barta is the one to watch! She’s on a mission to alleviate the grueling process some go through when dealing with eczema.

In this 45 minute webinar, Kelly expresses the importance of becoming an eczema advocate. Advocates have a voice, raise awareness, and address issues that eczema patients are dealing with.

Step Therapy – (affects a lot of eczema patients) – took 2.5 years, but finally got it passed this spring. State and Federal Bills

Fail First – patients take less expensive drugs before the insurer will cover the medication originally prescribed by the doctor

NEA Policy Priority – advocate for the passage legislation that would amend step therapy requirements when the patient has already tried and failed the “step” drug, due to ineffective results or side effects. The goal is to put the care back into the patients and doctors hands and out of insurance hands

Access to care –

Prior Authorization – Your health care provider needs approval from your insurance company before prescribing a particular medication. This adds an unnecessary burden delaying a patient’s access to medication, which ultimately delays skin relief 

Non-Medical Switching – When insurers change the list of drugs that it covers during a contract year. This causes the patients to switch over to new drugs, instead of keeping the previous ones as they are no longer covered under the insurance. 

*There are some states that ban mid-year formulary changes, unfortunately, most do not. 

Out-Of-Pocket Costs – The cost of “specialty drugs” are being passed on to patients by insurance companies in higher co-payments. <— advocating to cap these costs on specialty drugs

Network Adequacy – the size of health insurer’s network of providers relative to the size of the insured population + ability to deliver covered benefits & services quickly for policyholders

Legislators need to hear from patients! 

Kathy Sage (Maryland) – Very active advocate who went through step therapy – had to take Protopic, Elidel, and Eucrisa before being subscribed dupixent. This process took her 9 months with 3 appeals 

Judi McCarthy (Pennsylvania) – Diagnosed with eczema a few years ago (in adulthood) starting with her hands and feet. She had to give up her career as a licensed massage therapist. She became reclusive because she wore white gloves to protect her hands. Diagnosed with depression and she had blood pressure medication. Steroid ointment wasn’t working. Insurance denied her dupixent and she ended up getting a horrible infection that sent her to the ER. The ER doctors explained that her open wound eczema led to the strain in her body for infections, which will not get any better as she will always be susceptible to it. They mention she needs to fight her insurance company, it’s the only way you’ll get better. The insurance denied her, but dupixent was able to send her medicine within a week. Within a month her eczema cleared up. 

Traciee Thomas (Oregon) – Working with representatives in the state of Oregon. Parent of a child with eczema and has eczema herself. Emphasize on never getting too tired or feeling like you’re invading their space when requesting what you want.

2020 Goals 

  • Bring Eczema Awareness Month to different states. In order to do with you reach out to senator or representative and ask them to sponsor a resolution, the NEA has created a language written up – making it a very easy process. Then it gets signed into law. 
  • Support the passing of Step Therapy Before Legislation – On both state and federal levels. Asking for – clearer & prompt timelines for insurers to respond (with 72 hours) if a life or death then within 24 hours, patients to remain on current drug and not have to switch, ensuring step therapy is on current clinical data, exceptions based on medical necessity 

How you can get involved – 

Sign up for advocacyhttps://nationaleczema.org/get-involved/advocacy 

  • participate in click campaigns
  • call your elected officials
  • in-person meetings with your elected officials
  • lead or participate in an advocacy committee in your state
  • educate yourself – advocacy training sessions
  • represent NEA on a national level
  • raise awareness EVERYWHERE by unhiding your eczema

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