State Issues

In 2014, the National Psoriasis Foundation started a concerted program to advocate for those living with psoriatic disease through efforts targeted at state and local government. As federal policy making on access to care issues continues to shift, the states are proactively and reactively responding by taking action on a range of health care issues that impact the psoriatic community. 

Access to Appropriate Treatment

The NPF state advocacy team elevates the patient voice in the effort to create a better environment for those living with psoriasis, so they have better access to health care in order to appropriately treat their disease. Elected officials want to hear from you, the voters in their districts, who are personally impacted by the issues they are setting policy on. Our efforts are guided by NPF’s strategic plan, which boldly seeks to increase the number of people receiving appropriate treatment. Together, we can impact policies that will improve access to treatment and enable people to better manage their disease!

Photo: NPF advocate leads a dialogue on access legislation with Texas House Speaker Joe Straus.


Working in Coalition

We partner with a diverse group of stakeholders while advocating for those with psoriatic disease in the nations statehouses. We are committed to working with anyone and any organization that shares the same goal we have - to find a cure to psoriatic disease and to improve access to care for our patient community. These partners include nationally recognized non-profits which represent other disease states, legislators, the pharmaceutical industry, pharmacy benefit managers, insurance companies, associations that represent health care industry related businesses, provider organizations, large employers, and local advocacy groups. 

Photo: NPF and coalition partners in New York hold a press conference urging pass of step therapy legislation.


Current State Priorities

We work on a number of issues concerning access to care in the states. Driven by our medical board’s Access to Care statement approved in March of 2014, we are able to elevate the patient and provider voice on a number of issues that are on the forefront of health care policymakers’ agendas. This includes advocating for policy solutions to access to care issues including step therapy and prior authorization, high out of pocket costs, biosimilar substitution, switching stable patients off therapies, and legislation that seeks to limit access to patient assistance programs.

Photo: Governor and Ambassador to China Terry Branstad signs a step therapy bill in to law.

Step Therapy
NPF’s state advocacy team is both a thought leader and direct-on-the-ground leader of coalitions in what has become a nationwide campaign to pass legislation that provides exceptions to step therapy protocols. This commons sense and bi-partisan legislation seeks to put the power of prescribing medications back in the hands of the physician and to restore the importance of personalized care by affirming the physician and patient relationship is the core driver of treatment decisions. The NPF team has led or co-led efforts to curb step therapy in eight states to date, and these campaigns have led to a groundswell of support for model legislation that the NPF team was instrumental in crafting.

Learn more about Step Therapy »
Out of Pocket Costs
High out-of-pocket costs force many individuals to stop taking their medications. Without treatment, many psoriasis and psoriatic arthritis patients risk serious health complications. NPF supports reigning in and limiting the maximum co-insurance and out-of-pocket expenses for individuals to enable them to have real access to affordable medications through well thought out, data supported, legislative solutions. The state team has successfully worked with coalitions regarding out-of-pocket cost legislation in Massachusetts, Oregon, New Jersey, and in the District of Columbia.
The introduction of biologic products for the treatment of psoriasis and psoriatic arthritis has been the most significant advancement in care for the psoriatic disease community in recent decades. Biologics have provided patients with an effective therapy—many for the first time in their lives. Biologics have also opened up a new world of combination therapies being used alongside systemic treatments, phototherapy and/or topical treatments. While it is the federal government’s Food and Drug Administration (FDA) that approves new therapies, states set the rules for drug substitution. The anticipated approval of interchangeable biosimilars has led the states to adjust their current drug substitution laws to allow access to these medications and, in most instances, the NPF team supports the legislation, which has now passed in well over half the states in the country. This collaborative effort has been so successful because stakeholders have long held an agreement regarding what the legislation should address and how. At the core of this campaign is the communication piece of the legislation which requires a pharmacist to notify the doctor in writing or electronic form that a substitution has occurred. The NPF team believes that the model biosimilar substitution bill strikes a balance between safety and access and is excited to see the momentum continue on such an important issue to those living with psoriasis and psoriatic arthritis.