Advocacy & Policy
New tool to help stop the costly infusion runaround
Download our template to request a blanket exception.
AGA is committing to protecting patient access to care – including keeping infusions in physician offices.
AGA is deeply concerned that independent practices are struggling to offer infliximab biosimilar infusions due to the high acquisition costs far exceeding reimbursement.
We have developed a templated letter that your practice can use to reach out to insurers to request a blanket exception to any infliximab fail-first mandates.
Steps to use AGA’s letter:
- Download the template (for AGA members only).
- Share with your medical director of infusion services or administrative staff that support prior authorization requests.
- Ask them to personalize based on your practice needs.
- Send to insurers.
- Keep AGA posted on the response you receive at [email protected].
AGA will not sit back and let insurers dictate how you care for your patients.
We are actively working to raise awareness of unjust insurer practices through media placements, legislative action, and by offering you resources, like this one.
Please email us and let us know any other challenges we can help with. We’re also interested to hear your patient stories that can help support our public advocacy against insurer overreach.
Deeper info about the runaround:
- The infliximab infusion runaround is part of the concerning power of pharmacy benefit managers (PBMs).
- As recently recognized by the Federal Trade Commission, pharmacy benefit managers wield enormous power over patients’ ability to access and afford their prescription drugs, allowing PBMs to significantly influence what drugs are available and at what price. This can have dire consequences, as we are seeing in our practices.
- Congress and regulators are waking up to PBMs anticompetitive practices and are interested to hear from physicians and patients about our struggles.
- It is primetime to get involved!
- Support AGA’s advocacy by sharing your story.
- Support the AGA PAC, which powers AGA’s advocacy for important issues like this.
Join the fight for the future of GI
AGA PAC is dedicated to increasing our members’ presence on Capitol Hill and supporting congressional candidates who protect the needs of GI patients and health care professionals.
