Today’s guest post comes from Pete Salzmann, M.D., vice president of Immunology at Lilly.
At Lilly, we’re proud to be part of the rheumatology community, to support leading scientists and researchers, and to partner with organizations and institutions around the world as we advance our work to improve patients’ lives every day.
However, challenges are facing the rheumatology field today, including access to innovative medicines, the heavy burden rheumatological diseases place on patients and their families, and the growing shortage of rheumatology professionals. While we don’t have all the answers, we’re working hard to contribute to potential solutions.
Access to innovative medicines
It is critical for patients to have access to innovative treatments that could help make a difference in their lives. However, it’s a complex issue. Take step therapy, for example, which is a practice seen more and more in our health system as financial pressures mount across the board. Despite what the doctor prescribes, when a step therapy program is in place, patients are required to start with a specified medicine which is “on formulary.” Patients must then wait until the formulary product fails before they can begin a non-formulary product, even if there’s an indication that it would benefit them more from the start.
To achieve good patient access in rheumatology, we need a variety of medicines from which physicians and patients can choose. Advanced therapies like anti-Tumor Necrosis Factors have been on the market a long time and are widely available. While effective for some patients, there are others who do not respond to them, or who see their benefits dissipate over time, requiring other options (that may or may not yet exist).
It’s important for patients to have multiple treatment options available to best suit their disease characteristics and experience. In addition to developing treatments that can meet the unmet needs of patients, Lilly is working to help more patients access the treatments prescribed by their healthcare providers. We believe patients deserve to get to the right treatment for them, as quickly as they can, because patients with progressive, rheumatic diseases don’t always have the luxury of time.
Reducing the heavy burden
With arthritis being a leading cause of disability in the United States, it shouldn’t come as any surprise the heavy burden arthritis and other rheumatological conditions place on patients, such as lost wages, high medical costs, physical pain and stress. In fact, with an extra $140 billion of medical cost in 2013 attributed to arthritis alone, the latest year for which data is available, the extra costs per adult with arthritis was $2,117. And that’s in addition to lost wages, which that same year totaled $164 billion, or more than $4,000 less than is earned by someone without the disease.
Effective and affordable treatment options are essential to controlling costs within the RA treatment space and delivering value to patients. The list price of our rheumatoid arthritis treatment is an example of how Lilly aims to put patients first. We launched at a list price 60% lower than the leading TNF inhibitor. We aim to deliver to patients and the health system by offering clinically meaningful disease control at a good value.
While list price plays an important role in treatment access, other factors determine what a patient pays, including their personal health plan’s benefit design and any financial obligations required in those plans. More needs to be done to reduce the financial and physical burden of these costly diseases for patients.
The growing shortage of rheumatology professional
With just under 6,000 adult rheumatologists in the U.S. and around 5,000 rheumatology nurses, only around 270 of whom are nurse practitioners, it’s becoming increasingly difficult to provide care for those who need it. In fact, there is an average of almost 49,000 adults with a rheumatology condition per rheumatologist.
Why the shortage? As the country’s population ages, there’s more demand than ever from patients experiencing rheumatological disease and less supply of rheumatologists to care for them as they themselves age and begin to retire. Research suggests that by 2030 – less than 12 years away – the supply of rheumatologists will be half of what will be needed.
Increasing the number of rheumatologists will require a concerted effort on many fronts. But it starts with education and encouraging emerging talent to enter the field. Together, we can create new and innovative methods to expand the workforce.
Moving forward together
Despite these challenges, we believe that the rheumatology field is ripe with opportunity and promise to help people who are impacted by these devastating and progressive diseases. We’re determined to work together with our partners and other stakeholders to make life better for people suffering from serious autoimmune conditions, such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, systemic lupus erythematosus and others.
Whether it’s through maintaining our commitment to develop novel medicines or improving the treatment experience, including patient access and care, we are optimistic about bringing innovation forward in hopes of reducing the burden of disease for people around the world.