My name is Katie Roberts and I’ve lived with a severe and debilitating form of psoriatic arthritis for nearly 40 years, and psoriasis, a painful skin condition, for nearly 30 years. I’m an Advocate for Arthritis and the Chair of the Maryland Advocacy committee because I’m passionate about sharing my story to break down barriers to care, especially step therapy.
At an appointment with a rheumatologist at age 17, I was told I would likely not live long enough to see my 21stbirthday – my body was slowly shutting down from years with an autoimmune disease. It was more than the arthritis and psoriasis. The autoimmune disease had started to affect my digestive system, bladder, liver, kidneys, heart, and lungs.
我的医生给我开了当时最好的治疗方案。这让我活过了我的预后，但它没有让我控制我的疾病。我的医疗团队开了无数的药，我甚至参加了国家卫生研究院的3个实验药物协议。
同年晚些时候，在2002年，一种生物药物，通过NIH的一项研究被提供。3周内，我就不用坐轮椅了，6周内我就能独立行走了。我的牛皮癣在8周内从身体覆盖率的80%下降到不到5%。
It was my miracle drug. It literally saved my life.我能够再次加入劳动力大军，并继续拥有一个非常成功的职业生涯。Little did I know then that all the progress that I made would be thwarted years later by step therapy.
I had been stable on my biologic treatment for years, with coverage for my biologic through my employers’ private insurance. In the middle of a plan year, my insurer sent me a letter informing me my biologic injections would no longer be covered under my plan until I went through “step therapy protocols”. They told me that I would have to try and fail a less-costly alternative treatment before they would to cover my biologic.
My insurer’s decision to force me through burdensome step therapy protocols not only interrupted my life, but it brought my life to a standstill. This step therapy decision was overly burdensome in three major ways:
- The process was nottransparent-没有规定我必须尝试多久才能失败的任何一个步骤的药物。
- Mydoctorsdid not have any power to appeal oroverride这个决定，我的医生试图反抗并帮助上诉保险的决定，但无济于事。
- My health plan did not take mymedical historyor my doctor’s medical opinion into account – it didn’t matter than my biologic was helping to control both my arthritis and my comorbidities like psoriasis and Chron’s disease, my insurer still wanted to try the lower cost alternative.
Within 4 weeks of going off treatment, I was back in a wheelchair也就是说，从一个功能齐全的成年人到坐轮椅只有四周的时间。如果不稳定的话，这就是这种疾病发展的速度。不幸的是，我被迫继续这个步骤治疗的旅程长达10个月——导致了14次手术，无数的医生拜访，耽误了工作时间，最终医疗费用远远超过了我的生物治疗的价格。
Earlier today, Congress introduced federal legislation calledthe Safe Step Act (HR 2279)这将在全国范围内改革逐步治疗方案。The three reforms proposed in the legislation will make step therapy a moretransparentprocess, that gives doctors the power tooverridestep therapy decisions when medically appropriate, and that takes into account personalmedical history. Had this bill been law in 2008, I would have had the power to avoid the burdensome step therapy protocols I encountered.
I need your help in teaching Congress about the importance of step therapy reform, and calling on our legislators to sponsor this important piece of legislation.Take five minutes to send your Member of Congress your support.
