The Senate has passed the Food and Drug Administration Reauthorization Act (FDARA), a legislative package that supplements FDA funding by requiring manufactures to pay user fees when submitting medical products for review in exchange for a timely approval process.
Held every September, the Rally for Medical Research brings together more than 300 hundred patient and physician advocacy organizations, universities, research centers and biopharmaceutical industry associations to support sustained federal investment in the National Institutes of Health (NIH).
As noted on the website, “The purpose of the Rally is to call on our nation’s policymakers to make funding for National Institutes of Health (NIH) a national priority and raise awareness about the importance of continued investment in medical research that leads to MORE PROGRESS, MORE HOPE and MORE LIVES SAVED.”
The 5th Rally for Medical Research will be held on September 14th in Washington, DC. Advocates are welcome to attend a training session followed by a reception on September 13th. For more information and to register, visit the Rally for Medical Research website. Sabah Bhatnagar, Program Director of Rare Disease Legislative Advocates, will be there so please look for her if you attend!
If you are unable to participate in-person, you can join the national Day of Action remotely. Show your support for funding for NIH on social media using the hashtag #RallyMedRes and follow the Rally on Twitter and Facebook. A Twitter cheat sheet, fact sheets on the importance of NIH funding and additional resources will be available on the Rally website.
After the narrow defeat of Affordable Care Act (ACA) replacement plans in the Senate, Senators have left for August recess without voting on other proposals. At the nail-biting conclusion of a week-long debate, the Senate voted 51-49 against the “skinny repeal” bill that would repeal mandates and many of the taxes associated with the ACA. Several Senators have realized that the only path forward requires bipartisan cooperation, despite a highly-polarized environment.
A bipartisan solution will most likely include state flexibility and market stabilization that Republicans desire and funding for cost-sharing subsidies that Democrats support. A recent Politico article states, “Republicans will seek a more flexible 1332 waiver — an existing Obamacare provision that allows states to make changes to the law’s requirements, according to GOP sources. Democrats say funding the approximately $7 billion annual payment to insurance companies to help cover low-income people is the minimum requirement for a deal. The Trump administration has said it is ready to pull the monthly payments at any time in response to the failed repeal effort, a move that could immediately drive companies off the exchanges and further undermine the Obamacare markets.”
Senate Health Education Labor and Pensions (HELP) Committee leadership will set the tone for future replacement proposals. Sen. Alexander (R-TN), the Chairman of the Committee, along with Sen. Murray (D-WA), the Ranking Minority, must bridge the chasm between viewpoints on opposite ends of the spectrum on the HELP Committee.
ACA replacement plans could have a critical impact on the rare disease community. Click here to read the full article from Politico.
Sabah Bhatnagar recently joined the EveryLife Foundation team as Program Director of Rare Disease Legislative Advocates (RDLA). She was previously the Government and Industry Affairs Coordinator at the Association of Clinical Research Organizations (ACRO), where she advocated for policy and regulation that support clinical research and the development of innovative, safe, and effective treatments and promoted a more efficient clinical trial process. As a Health Policy Communications Associate at the Alliance for Health Reform, a non-partisan organization focused on educating policy-makers about health policy, she helped execute over 70 events on a variety of health policy topics.
Sabah is a rare disease patient and holds a B.S. in biology from the University of Mary Washington. She is based in Washington, DC and looks forward to engaging the rare disease community.
The President’s budget has dominated headlines since it was released yesterday, prompting concerns from many in the healthcare sector and questions among advocates about what it means. You can find the budget and supplemental materials here.
Federal Budget Process
This two minute video from AAAS explains the long process of creating and passing the federal budget. While the President makes a recommendation, it is up to Congress to pass funding bills. It is important for rare disease advocates to contact their legislators to request funding for the federal programs they support.
Funding for National Institutes of Health (NIH)
The proposed budget would reduce funding for NIH by $5.8 billion. Congress recently passed a budget with an increase in NIH funding for the remainder of FY2017 despite the President’s call for a reduction, and there is bipartisan support for biomedical research funding. Many health advocacy groups voiced opposition to the proposed cut, as did the Chairman of the House Appropriations subcommittee that oversees health.
“The drastic cuts in the Administration’s 2018 budget for the National Institutes of Health (NIH) are a significant blow to medical research and the patients who depend on it.” –United for Medical Research
“Steep funding cuts for the federal health agencies are counterproductive at a time when innovative research is moving us closer to identifying solutions for rare diseases, new prevention strategies to protect Americans from deadly and costly conditions, advances in gene therapy, new technologies for understanding the brain, and treatments that harness the ability of our immune system to fight cancer.” – Research!America
Funding for Food and Drug Administration
The Administration’s proposed budget would cut funding for FDA by $871 million and increase the amount of user fees. The user fee agreements between FDA and industry were finalized last year and the reauthorization process is underway in both the House and the Senate. The user fee agreements must be reauthorized by July 31st or the FDA must begin to notify the staff who review new medicines ad devices of potential layoffs.
“We are concerned that should the FDA, as a consequence of this proposed budget shift, become significantly underfunded, the agency will have to choose among important public health priorities. Beyond the needed investment in FDA’s core functions, sufficient funding is necessary to spur innovation and provide critical oversight initiatives for drugs, biologics, and food.” – Muscular Dystrophy Association
Funding for Other Health Programs of Interest to Rare Disease Community
The budget also includes a cut of nearly 20% for the Children’s Health Insurance Program (CHIP) as well as cuts to Medicaid. A speaker from the American Academy of Pediatrics explained the importance of both programs at the Legislative Conference during Rare Disease Week on Capitol Hill earlier this year. You can access the video and slides here.
What You Can Do to Impact the Budget
To start, call or write your legislators to ask them to support funding for the federal programs that are most important to you. You can find their contact information here.
You can also participate in In-District Lobby Days during the summer Congressional recess from August 7th through September 6th. When you register, you can specify when you are available and how far you can travel. We’ll schedule meetings for you in the local offices of your Representative and Senators based on that information, and hold a webinar on July 28th to help you prepare.
The EveryLife Foundation and Global Genes are joining together to host a series of RARE on the Road events this summer to educate rare disease patients, caregivers and other advocates in an interactive and engaging environment.
Building on the successful regional Legislative Conferences hosted by Rare Disease Legislative Advocates, the RARE on the Road events will highlight topics from capacity building to a patient’s role in drug development, including a hands-on workshop and networking lunch. These FREE regional events will help advocates learn, grow and become independent activists for their rare disease community. The general agenda for all three events is available here.
Registration is available by clicking the links below. Each event will run from 8:30am through 4:30pm.
Saturday, May 13th, 2017: Loudermilk Conference Center, Atlanta, GA
Monday, June 5th, 2017: Kauffman Foundation Conference Center, Kansas City, MO
Saturday, July 15th, 2017: Shriners Hospital for Children, Portland, OR
A limited number of $100 travel scholarships are available for rare disease patients and caregivers who otherwise would not be able to attend. Applications are available online and are due one month before each event, except for applications for a scholarship to RARE on the Road in Atlanta which are due by April 20th.
You can help spread the word by sharing the flyer (available here) with your community.
Facebook and Twitter provide opportunities to engage state and federal policymakers as well as other rare disease advocates who can take action on their own and/or increase the reach of your message.
You can find a list of Twitter handles for U.S. Senators here, and another for members of the U.S. House of Representatives here. The National Conference of State Legislatures has a list of state legislative social media websites that is available here.
How can YOU use social media? Below are several examples. For all of them, make sure to tag your legislators on Facebook and use their official Twitter handles to make sure they see your posts.
- Encourage your legislators to support or oppose specific legislation, and thank them when they do.
- Are your Representative and Senators members of the Rare Disease Congressional Caucus? Tweet to thank them if they are or ask them to join if they are not, and post a respectful request on their Facebook pages.
- Thank legislators (or their staff) for meeting with you, especially if they agree to something you requested such as supporting legislation. Take a photo to include in your post, if possible.
- Use your Twitter account to ask your followers to take action. Retweet action alerts from other organizations that you support in order to expand the number of people who see it and participate.
- You can also increase the number of people who participate in action alerts by sharing them on Facebook. Rare disease advocacy organizations rely on help from individual advocates who not only take action, but call on their friends and family to do so as well.
Emily Eckland, Digital and Social Media Communications Manager for Eli Lilly & Company, discussed Best Practices for Staying in Touch and Social Media to Build Momentum at the Legislative Conference during Rare Disease Week on Capitol Hill. The video of her presentation is available on the Legislative Conference resource page.
The Rare Disease Congressional Caucus hosted a briefing during Rare Disease Week on Capitol Hill which focused on Advancing Rare Disease Treatments in the Era of Cures and Health Care Reform.
After welcoming remarks from Caucus Co-Chair Senator Amy Klobuchar (D-MN), the panelists addressed implementation of the 21st Century Cures Act, reauthorization of the Prescription Drug User Fee Act, efforts to repeal and replace the Affordable Care Act, new models for rare disease drug development such as repurposing, and the role of incentives to encourage the development of orphan therapies.
The free 21st Century Cures tracker focuses on the more than 100 sections in Division A, which include the key provisions on biomedical research:
“A few examples of the issues we will be tracking include the impact of changes to the National Institutes of Health’s administrative requirements for grantees, how the Food and Drug Administration implements new changes designed to enhance patient engagement and how the Department of Health and Human Services is using its new authorities to promote health information technology interoperability.
Many external factors will affect the progress of these initiatives, including policies related to hiring freezes and uncertain funding levels.”
FasterCures welcomes your feedback and suggested updates for the tracker, which can be submitted here.
Timely reauthorization of the Prescription Drug User Fee Act (PDUFA) was one of the hot issues discussed during the Legislative Conference during Rare Disease Week on Capitol Hill.
First enacted in 1992, PDUFA enables the Food and Drug Administration (FDA) to collect user fees from biopharmaceutical companies in order to enable the Agency to review the safety and efficacy of new medicines more quickly. According to PhRMA, it took FDA more than two years to review new medicines and more than 70% of medicines were approved outside of the U.S. before PDUFA.
Every five years, FDA and the biopharmaceutical industry negotiate a new user fee agreement, which Congress must enact in legislation. PDUFA was reauthorized in 2012 in the Food and Drug Administration Safety and Innovation Act, which also included provisions creating the Breakthrough Therapy designation as well as the Rare Pediatric Disease Priority Voucher program. PDUFA is due to be reauthorized this year, as the current user fee agreement expires on September 30th.
Released last year, the draft PDUFA VI agreement includes specific performance goals for drug review, proposed plans for enhanced use of biomarkers, expanded patient engagement, and improved specialization of reviewers for rare diseases.
The Senate Health, Education, Labor and Pensions Committee will convene a hearing on PDUFA reauthorization on March 21st at 10am ET with testimony from senior FDA leadership, and will be available by livestream. The House Energy and Commerce Subcommittee on Health will hold a hearing on PDUFA on March 22nd at 10:15am.
As discussed on the March webinar, it is important for PDUFA to be reauthorized by the end of July or FDA will need to send furlough notices to staff who review new medicines.