Protecting Patients’ Hope & Better Health
More than 30 years ago, John “CZ” Czwartacki was diagnosed with multiple sclerosis at 23 years old. At that time there was not a single approved treatment to slow its progression. Without tools to fight, doctors told him to him there was nothing they could do. He should go home, try not to think about it, and hope for the best.
That hope was not misplaced. Innovation came through — more than once. It gave him back the chance to pursue his career, a family of his own, and, most unexpectedly, a passion for painting.
This is his story. And it is a story that includes his work standing up for patients’ hopes and fighting policy that robs their future.
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Threats to Innovation
“When the government sets the price, it determines what doesn’t get developed next.” - CZ
Government price setting policies, including international reference pricing proposals, will remove incentives to take the risks needed to bring a new cure to market:
We’ve already seen this with the Inflation Reduction Act (IRA). Since the passage of the law in 2022, innovation has begun to dry up.
A total of 56 research projects and 26 drugs have been discontinued since the law’s passage (Incubate Coalition)
International reference pricing poses a new threat.
Recent analysis shows that 110 breakthroughs launched in the United States in the past five years are still unavailable in Europe today. (IQVIA)
“Most Favored Nation” (MFN) international reference pricing proposals would tie the U.S. healthcare system to these countries.
MFN-pricing proposals would slash U.S. research spending by half, which could lead to 500 fewer new medicines over the next decade (University of Chicago)
“...there are drugs that will not be developed that could benefit untold people.” - CZ
Barriers to Care
“Innovation means nothing if patients can’t access the treatments their doctors prescribe.” - CZ
Prior Authorization
Prior authorization requires patients to get approval for a physician-prescribed medication before they can receive coverage.
This allows payers to override doctor judgment to delay or deny care based on cost, not what will work best for that patient.
Prior authorization is a cost-cutting mechanism disguised as a clinical tool.
Step Therapy
Step therapy requires patients to try and fail cheaper, often less-effective medications before they can get coverage for one that works for them.
For patients with serious or chronic conditions, being forced to try and fail on inferior treatments can mean weeks or months of inadequate care, unnecessary side effects, and disease progression that cannot be undone.
Solutions
Survivors for Solutions urges Washington to reject price-setting policies that will remove the incentives for innovation.
These include international reference pricing proposals, including “Most Favored Nation” (MFN) and calls to expand the Inflation Reduction Act (IRA) drug price “negotiations.”
Lawmakers should also unequivocally reject MFN policies that would embrace discriminatory valuation metrics, like the quality-adjusted life year (QALY) that put older and disabled patients at the back of the line.
For patients managing rare, chronic, or life-threatening conditions, prior authorization and step therapy are not administrative inconveniences; they are barriers that waste precious time, override doctor judgment, and allow disease to progress in ways that cannot be undone. Lawmakers should act to curtail both practices where not needed.
To check out more of CZ’s artwork, click here.
