Putting Patients First: Digestive Disease Week

More than 100 autoimmune diseases affect more than 150 million Americans including the millions of patients who suffer from gastroenterology disorders. This is Digestive Disease Week, and Let My Doctors Decide joins patient groups, providers, researchers, and other stakeholder to call attention to challenges posed by these disorders and continued access restrictions that hinder patients access to doctor-prescripted medicines and treatments, further delaying health and wellness.

LMDD’s Patient-Centered Contracting Principles are designed to improve access and affordability for all patients including those with digestive disease disorders. This includes actionable policies and reforms for policymakers, employers, and insurers that address the restrictions that prevent patients from getting doctor-prescribed medicines and treatments including harmful step therapy requirements and other access barriers imposed by insurers and pharmacy benefit managers – PBMs. Changes are needed at the national and state levels that improve benefit design and ensure coverage that empowers provider decision-making, promotes access and adherence, and addresses affordability.

The LMDD Principles:

  • Require that step therapy policies are clinically based on current evidence and used for medical reasons only.

  • Prohibit switching of medication for non-medical reasons without the prescribers’ consent.

  • Leave the final decisions to whether a patient has failed on a therapy with the treating physician, not the insurer.

  • Pass rebates, discounts, copay assistance, and other insurer and non-insurer savings directly to the patient at the pharmacy counter.

  • Assure that what is best for the patients’ health, as determined by patients and their treating physicians, is top priority and is made transparent in health care contracting, including benefit design and coverage policies.

Read more from patients, advocates, and providers who are battling digestive orders – their personal stories, challenges, and victories. With the promise of new treatments and medicines of tomorrow, it will be even more critical that all patients have uninhibited access to doctor-recommended treatments to ensure the path forward to health and wellness. It’s time to put patients first.

Farheena Mustafa