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.
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.
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 National Institutes of Health (NIH) is the largest biomedical research agency in the world committed to improving health by conducting and funding research. Significant cuts to the NIH budget in the President’s Fiscal Year (FY) 2018 budget and proposal for the remainder of FY2017 are of significant concern to patients and researchers, and threaten the pace of scientific discovery.
NIH has several initiatives focused on increasing understanding of rare diseases and the speed at which new treatments are developed. These include the Rare Diseases Clinical Research Network, Office of Rare Diseases Research and Therapeutics for Rare and Neglected Diseases program as well as the Undiagnosed Diseases Network, which seeks to provide answers to patients with rare genetic diseases and the Clinical Center, which is the largest hospital dedicated to clinical research in the U.S.
Data in a new report illustrates that NIH research creates jobs across the country and helps make the case that funding should be increased, not decreased. According to United for Medical Research (UMR), research funded by NIH supported close to 380k jobs and $64.799 billion in economic activity in FY2016.
“NIH-funded research is an engine for economic and medical progress, making the drastic cuts to the NIH proposed in the President’s initial budget doubly dangerous. These cuts will stymie the jobs creation and economic activity happening today as a result of NIH-funded research and they will slow down or completely stall critical research on a range of diseases, including some of our most costly health problems…” stated UMR President Lizbet Boroughs.
You can find the impact of NIH funding in your state here. The one-pager on the need for increased funding for NIH and the Food and Drug Administration (FDA) from the Lobby Day during Rare Disease Week on Capitol Hill is available here, and a video of the presentation on this topic by Sara Chang of Research!America during the Legislative Conference can be found here in the section entitled “Rare Disease Legislation in the Queue”.
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.
Thank you to the 600+ rare disease patients, caregivers, researchers and other advocates who joined us for at least one event during Rare Disease Week on Capitol Hill in Washington, DC from Monday, February 27th, through Thursday, March 2nd.
The week began at the National Institutes of Health (NIH), where the EveryLife Foundation’s Chief Advocacy and Science Policy Officer presented an update on our work to improve the state newborn screening system and create incentives to encourage biopharmaceutical companies to repurpose approved medicines for rare diseases.
That evening, we hosted a cocktail reception, screening of the documentary Up for Air, and panel discussion. Senator Ed Markey (D-MA) and Representative Jim McGovern (D-MA) made brief remarks.
Aproximately 350 advocates joined us for the Legislative Conference on Tuesday, which was livestreamed for the first time. Experts from Capitol Hill and patient advocacy organizations discussed what to expect from the new Congress and Trump Administration, how to build effective relationships with Members of Congress and staff, and key legislation. Video and presentations will be available on the Legislative Conference resource page.
Advocates began Lobby Day at breakfast with remarks by Dr. Janet Woodcock, Director of the Food and Drug Administration’s Center for Drug Evaluation and Research, as well as Representative Gus Bilirakis (R-FL) and former Representative Brian Baird (D-WA), who urged advocates to be brief, polite and persistent in their meetings with Members of Congress and staff.
328 rare disease advocates participated in 270 Lobby Day meetings, discussing the Rare Disease Congressional Caucus, healthcare reform, incentives for rare disease drug development and other key legislative topics.
On Wednesday evening, we hosted the annual Rare Artist Reception which featured winning entries from the 2016 contest and remarks from several of the artists.
The final event of the week was a Rare Disease Congressional Caucus briefing entitled, ” Advancing Rare Disease Treatments in the Era of Cures and Health Care Reform.” Caucus Co-Chair Senator Amy Klobuchar (D-MN) welcomed advocates and Congressional staff. Video will be posted on the Caucus webpage within a few weeks.
On January 23rd, President Trump instituted an immediate hiring freeze that would affect many federal agencies including the National Institutes of Health (NIH) and the Food and Drug Administration (FDA). Unfortunately, this freeze could significantly hamper research into rare disease treatments as well as the review and approval of new medicines. The EveryLife Foundation for Rare Diseases is asking patient organizations to sign-on to a letter describing the critical importance of the NIH and FDA along with their ability to hire new staff.
The Foundation is accepting signatures until Friday, February 24th, so sign on today! Your voice provides needed perspective on how the hiring freeze could harm rare disease patients. Share this action alert with your networks and on social media.