ACR Releases New Step Therapy and Drug Pricing Position Statements

Stethoscope on medical billing statement on table, all text is anonymous
The ACR has released updated drug pricing and step therapy position statements.

The American College of Rheumatology (ACR) has released updated drug pricing and step therapy position statements in order to urge legislators to explore regulatory options that will make drugs more affordable and accessible.1

“We continue to emphasize these topics because they are so critical to the well-being of millions of Americans living with rheumatic diseases, some of which can be quite debilitating and even lead to death,” stated Colin Edgerton, MD, chair of the Committee on Rheumatologic Care at ACR. “The need for patients to have access to prompt, affordable, and medically necessary treatments is ongoing and should be considered at every step of the policy making process.”

A summary of the ACR’s position on drug pricing is as follows:

  • Patients with rheumatic disease should have safe and affordable access to treatment that controls disease activity and prevents permanent joint and organ disease.2
  • The agency supports policies that mitigate rapid escalations in treatment prices.2
  • Transparency should be encouraged in the prescription drug pricing policies used by pharmaceutical manufacturers, pharmacy benefit managers, and health insurance companies.2
  • A safe and efficient biosimilar approval pathway and marketplace will lower costs and improve access to treatment.2
  • Proposals to address rising drug prices must address the cost to the healthcare system, continuity of care, and out of pocket affordability to patients.2
  • The agency supports preserving patient access to physician-administered drugs by recognizing the rheumatologists’ role in providing specialized, continuous care.2

Related Articles

In addition, to improve access to appropriate treatments, the ACR suggests the following:

  • The agency supports strategies that lower the cost of expensive therapies but opposes cost saving plans that compromise quality of care.3
  • The agency does not support step therapy, fail-first policies, or tiering of medications based on cost.3
  • Access to medically necessary treatment should be timely and not be delayed by unnecessary barriers.3
  • Healthcare stakeholders deserve transparency in formulary decision-making processes.3
  • Pharmacy review committees should include rheumatologists when developing formulary benefits programs.3
  • Nonmedical switching in a medically stable patient solely for cost savings and without the consent of the patient and provider is inappropriate and may be harmful to the patient’s health.3


1.       American College of Rheumatology Targets Step Therapy and Drug Pricing in New Position Statements [press release]. Atlanta, Georgia: American College of Rheumatology. Published April 1, 2019. Accessed April 1, 2019.

2.       Committee on Rheumatologic Care. American College of Rheumatology Position Statement: Drug Pricing. Accessed April 1, 2019.

3.       Committee on Rheumatologic Care. American College of Rheumatology Position Statement: Step Therapy. Accessed April 1, 2019.