Wed. May 11th, 2022

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[Editor’s note: This story originally was published by Real Clear Health.]

By Rep. Gale Adcock
Real Clear Health

When someone is diagnosed with a chronic illness, their first hope and expectation is to immediately receive effective treatments to manage their condition. Yet for many patients who suffer from Rheumatoid Arthritis (RA), that expectation is infrequently met.

People respond differently to different treatments, especially those with autoimmune diseases like RA, so it’s not immediately clear which one will be effective. Most RA patients have to try multiple treatments before finding one they respond to – a process that’s time consuming, expensive, and detrimental to their health.

RA is a debilitating autoimmune and inflammatory condition that leads to joint destruction and causes symptoms including intense joint pain and body stiffness. As a nurse practitioner of more than three decades, I’ve seen firsthand the terrible toll that RA has on patients. Today, roughly 1.5 million Americans – most of them women in the prime of their lives – suffer from RA.

The key to achieving positive health outcomes is to begin treatment as early as possible – before irreversible damage occurs. Of the five treatments options available, roughly 90% of patients are initially prescribed a tumor necrosis factor inhibitor (TNFi), according to Clinical Rheumatology. However, a study published in Arthritis Research & Therapy determined that a majority of patients do not respond adequately to TNFi treatments. These patients are left with a trial-and-error odyssey as they search for a treatment that actually works for them. Precious time is lost in getting the disease under control.

Another study suggested that RA patients who don’t respond to TNFi treatments had significantly higher rates of hospitalizations and emergency room visits than those who do respond. This translates to a significant financial burden for patients and the health care system.

Fortunately, help is arriving. A cutting-edge, predictive drug response blood test is now available, which can help eliminate the current trial-and-error treatment approach and instead match patients with their most effective therapy from day one. Essentially, this test analyzes a patient’s unique biology and determines whether they will respond to TNFi therapies. If this novel test suggests response is unlikely, the treating provider can more quickly move the patient to other options.

This isn’t a new concept. Many cancer patients are given biomarker tests to determine which type of chemotherapy is most likely to be effective against their specific cancer. These tests help countless patients get the most precise treatment right way and produce the best results. We now have the technology to help millions of RA patients in the same way.

Last year, the Centers for Medicare and Medicaid Services (CMS) tasked Palmetto GBA, a health care provider that covers North Carolina and other states, to gather evidence about predictive drug response testing for RA. In December, they held a hearing with respected rheumatologists who all testified that predicative testing would be an invaluable tool for providers and patients, signaling a possible positive step forward in making this advancement widely accessible.

Every day, Americans suffering with RA are forced to waste precious time while the condition insidiously leads to joint destruction, causes chronic pain, and saps their quality of life. Predictive drug response can change this current reality. It is imperative for CMS and its affiliates to make these tests as widely accessible as possible by ensuring they are covered by Medicare and Medicaid.

Gale Adcock is the deputy Democratic leader in the North Carolina House of Representatives and a family nurse practitioner. She has also served as president of the North Carolina Nurses Association, chair of the North Carolina Center for Nursing and was a member of the North Carolina Board of Nursing.

[Editor’s note: This story originally was published by Real Clear Health.]

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