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New York Bills Would Protect Patients from Non-Medical Switching

New York is taking steps to limit insurance companies from forcing patients to switch medications based on cost.

S. 5022 and A. 2317 would prohibit a health care plan from making prescription drug formulary changes during a contract year. S. 5022 was introduced in March 2017 and A. 2317 was introduced in January 2017. Currently, the A. 2317 has passed the Assembly and is waiting for S. 5022 to catch up. S. 5022 is in the Committee on Insurance. The sponsor memo for the bill says: 

Section 1 creates a new section 4909 of the Insurance Law to state that a health care plan which provides essential health benefits under the federal affordable care act may not remove a prescription drug from a formulary during the enrollment year. If the plan’s drug formulary has two or more tiers of drug benefits with different deductibles, copayments or coinsurance, the plan may not move a drug to a tier with higher patient cost sharing during the enrollment year. The plan may also not add new or additional formulary restrictions during the enrollment year. A health care plan may move a prescription drug to a tier with a larger copayment, coinsurance and different deductible if an AB-rated generic equivalent drug is added to the formulary at the same time.

A doctor holding a heart and a businessman holding money

Non-medical switching negatively impacts patients by disrupting their care and does not generate cost savings for the patient or the insurer.

A recent NIH study found that patients who had been switched off their preferred medication had more doctor office visits, experienced new or worse medication side effects, and had problems with their new prescriptions not working. This issue is further complicated for people with diabetes because insulins on the market are not identical. When a patient is switched from one insulin to another, the patient’s dosing and administration requirements change. DPAC has done several posts on non-medical switching. You can read DPAC’s statement, read a patient’s view on non-medical switching, and read a guest blog by Christopher G. Parkin

Show your support for S. 5022 and A. 2317! We need to send a message to get this bill out of committee!

Click here to send a letter to the New York Legislature asking them to support these bills!

South Carolina Bills Would Ban PBM Gag Clauses on Pharmacists!

The South Carolina House is entertaining bills that would, among other things, prevent pharmacy benefit managers from imposing gag clauses on pharmacists.

S. 0815 / H. 5038 / H. 5044 would prevent PBMs from putting gag clauses in their contracts with pharmacists. The bill was introduced in the Senate in December 2017, and in the House in March 2018. The bill has passed the Senate, and currently is in the Committee on Medical, Military, Public and Municipal Affairs. In part, the bill reads:

“A pharmacy benefit manager may not: (1) prohibit a pharmacist or pharmacy from providing an insured information on the amount of the insured’s cost share for a prescribed drug and the clinical efficacy of an alternative drug, if available. The pharmacist or pharmacy may not be penalized by a pharmacy benefit manager for disclosing such information to an insured or for selling an available alternative drug[…]”

Pharmacy benefit managers can tell your pharmacist what to say – and it could cost you money.

A doctor's hands in handcuffs.

Currently, some pharmacists are not able to tell patients when they could be paying less for their medications because PBMs put gag clauses in their contracts. PBMs sometimes set the copay price of a drug (what you pay if you used insurance) higher than the list price of the drug (the price you pay without using insurance). When insurance companies do this price setting, it is called a “clawback.” Gag clauses order a pharmacist not to tell you about the clawback, so they cannot say if you could pay less for a drug if you did not use your insurance. This results in higher prices for the patient. This practice is especially detrimental for people with diabetes because they pay about 2.3 times more on healthcare than people without diabetes. Gag clauses are surprisingly widespread; some independent pharmacists estimate that if they were allowed, they could have saved their patients money in about 10% of transactions. DPAC has done a deep dive into gag clauses on our blog.

South Carolinians, don’t lose this chance! Tell the House that you don’t want PBMs telling your pharmacist what they can and cannot say!

Click here to send a letter to the South Carolina House asking them to support S. 0815 / H. 5038 / H. 5044!

Pennsylvania Bill Would Ban PBM Gag Clauses

The Pennsylvania Senate is entertaining a bill that would, among other things, prevent pharmacy benefit managers from imposing gag clauses on pharmacists.

SB 637 would prevent PBMs from putting gag clauses in their contracts with pharmacists. The bill was introduced in April 2017, and reintroduced in December 2017. Currently, the bill is in the Appropriations committee. In part, the bill reads:

“(E) PHARMACY BENEFIT MANAGER OR INSURER CONTRACTS WITH PHARMACIES MAY NOT CONTAIN A PROVISION THAT PROHIBITS PHARMACISTS FROM DISCLOSING INFORMATION TO A CUSTOMER THAT WOULD REDUCE THE CUSTOMER’S OUT-OF-POCKET COSTS FOR PRESCRIPTION DRUGS.”

Pharmacy benefit managers can tell your pharmacist what to say – and it could cost you money.

A doctor's hands in handcuffs.

Currently, some pharmacists are not able to tell patients when they could be paying less for their medications because PBMs put gag clauses in their contracts. PBMs sometimes set the copay price of a drug (what you pay if you used insurance) higher than the list price of the drug (the price you pay without using insurance). When insurance companies do this price setting, it is called a “clawback.” Gag clauses order a pharmacist not to tell you about the clawback, so they cannot say if you could pay less for a drug if you did not use your insurance. This results in higher prices for the patient. This practice is especially detrimental for people with diabetes because they pay about 2.3 times more on healthcare than people without diabetes. Gag clauses are surprisingly widespread; some independent pharmacists estimate that if they were allowed, they could have saved their patients money in about 10% of transactions. DPAC has done a deep dive into gag clauses on our blog.

Pennsylvanians, the time to act is now! Tell the legislature that you don’t want PBMs telling your pharmacist what they can and cannot say!

Click here to send a letter to the Pennsylvania Senate asking them to support SB 637!

Senate Hearing on Insulin Pricing

On May 8, the Senate Special Committee on Aging held a hearing on “Insulin Access and Affordability: The Rising Cost of Treatment.” While we are pleased that the Senate is aware of this important issue, the hearing left us frustrated with its lack of meaningful solutions.

US Capitol Building

Quick Recap

The hearing was typical. First, Chairman Senator Susan Collins and Ranking Member Senator Bob Casey made statements on why the high price of insulin is an important issue that Congress should address.

Four witnesses gave oral testimony and then answered questions. The first witness was Dr. William T. Cefalu from the American Diabetes Association. He gave testimony on the need for transparency in the insulin pricing system.

The second witness was Paul Grant, the father of a son With type 1 diabetes. He discussed how he gets his son’s medication from a foreign country in order to pay less for it. Mr. Grant purchased his insurance through the marketplace with a high-deductible plan. Unlike previous years with predictable costs, he was shocked to find the price of insulin was high, as he had not met his deductible for the year. 

Next, Lois Ondik, a retiree, gave testimony on how she has avoided having to use medication to manage her type 2 diabetes by going to a diabetes self-management program. She does not currently use insulin in her daily diabetes management.

Finally, Dr. Jeremy Greene from the Johns Hopkins University School of Medicine gave testimony on the lack of generic insulins available to his patients.

A video of the entire hearing as well as all statements can be found here.

The Senators mostly asked questions about how to make the insulin pricing system more transparent. Dr. Cefalu called for transparency across the entire pricing system, from manufacturers, to pharmacy benefit managers, to insurance companies, to pharmacies. Dr. Greene proffered that if there were generics on the market, insulin prices would come down in order to be competitive.

Insulin pens

rDNA Human Insulin and Analog Insulin

There were two troubling issues in this hearing that bear examination.

First, neither the physicians nor the patients giving testimony discussed using less expensive, human insulins, like rDNA R and rDNA NPH, to avoid the extreme consequences of going without insulin. Dr. Greene discussed how his patients sometimes skip doses of their insulins because they cannot afford what he prescribes, but he did not say that he had the option to prescribe these low-cost insulins. The hearing was on access and affordability, and the “older” insulins meet both criteria. 

This is contrary to what he provided in written testimony, in which he states that there are less expensive insulins (rDNA human insulin) rather than the more expensive insulin analogs and that in fact, no longitudinal studies have shown that analogs are superior to rDNA.

This is taken from his written testimony (p. 9):

Dr. Greene's testimony

Dr. Greene’s oral testimony that there is no low-cost insulin on the market does not make sense when compared to the paragraph above, in which he writes that analog insulins are only slightly superior to rDNA insulins. If analog insulins are not significantly better than low-cost rDNA insulins, why didn’t Dr. Greene discuss the option of prescribing rDNA options to his patients who could not afford their analog insulins?

The second issue with this hearing is that it was very focused on transparency in the pricing system. More knowledge is always better, but in the case of insulin pricing, knowing how it is priced will not change the price. Simply put, knowing what something costs does not mean you can buy it. We would hope that Congress would put more effort into making insulin affordable and accessible rather than making pricing transparent.

What Can You Do?

DPAC provides a program called the Affordable Insulin Project, which is aimed at getting employers to exempt insulin from health insurance deductibles. The AIP gives you worksheets and tools to fill out and bring to your employer’s benefits manager to show them how much you spend on healthcare each year and what effect exempting insulin would have on your (and their) bottom line. And for those without employer-based insurance, there is a page dedicated to patient assistance programs.

Check out the Affordable Insulin Project today!

 

New Yorkers Have an Opportunity to Ban PBM Gag Clauses!

The New York Assembly is entertaining two bills that would, among other things, prevent pharmacy benefit managers from imposing gag clauses on pharmacists.

S07191A and A09893 would prevent PBMs from putting gag clauses in their contracts with pharmacists. The bills were introduced in January and February of 2018. Currently, both bills are in committee: S0719A has been referred to the Health Committee, and A09893 has been referred to Insurance. In part, the bills read:

“…no contract for pharmacy services entered into in the state between a health insurance carrier or a pharmacy benefit manager […] and a pharmacy […] shall contain a provision prohibiting or penalizing, including through increased utilization review, reduced payments or other financial disincentives, a pharmacist’s disclosure to an individual purchasing prescription medication of information regarding (a) the cost of the prescription medication to the individual, or (b) the availability of any therapeutically equivalent alternative medications or alternative methods of purchasing the prescription medication, including, but not limited to, paying a cash price, that are less expensive than the cost of the prescription medication to the individual.”

Pharmacy benefit managers can tell your pharmacist what to say – and it could cost you money.

A doctor's hands in handcuffs.

Currently, some pharmacists are not able to tell patients when they could be paying less for their medications because PBMs put gag clauses in their contracts. PBMs sometimes set the copay price of a drug (what you pay if you used insurance) higher than the list price of the drug (the price you pay without using insurance). When insurance companies do this price setting, it is called a “clawback.” Gag clauses order a pharmacist not to tell you about the clawback, so they cannot say if you could pay less for a drug if you did not use your insurance. This results in higher prices for the patient. This practice is especially detrimental for people with diabetes because they pay about 2.3 times more on healthcare than people without diabetes. Gag clauses are surprisingly widespread; some independent pharmacists estimate that if they were allowed, they could have saved their patients money in about 10% of transactions. DPAC has done a deep dive into gag clauses on our blog.

We need New Yorkers to speak up! Tell the legislature that you don’t want PBMs telling your pharmacist what they can and cannot say!

 

Click here to send a letter to the New York Assembly asking them to support S07191A and A09893!

Accumulator Adjustment Programs Put Added Burden On People with Diabetes

If you use a copay or discount card to purchase your medicine, listen up. You may find that last year, your deductible was met with a combination of your copay card payment and your personal payment. This year, your insurance plan may have a trick up their sleeve… and it can cost you thousands of dollars!

Paper reading "health insurance" with a pen and calculator

The Current Way Accumulators Work

Many people rely on copay cards or other discount cards to get their brand-name medications. For most people who utilize them, the process goes like this:

Jada has a high-deductible insurance plan with a deductible of $1000.

Jada goes to the pharmacy to pick up her medication with a copay card provided by the manufacturer. A medication costs $200. The card covers $175 of the cost of the medication (paid by the manufacturer), so she pays the remaining amount: $25.00.

Her insurance company then processes the payments and the total $200 gets applied to Jada’s deductible or out-of-pocket obligation. Jada meets her deductible within five months. 

How Accumulators Work with an Accumulator Adjustment Program

With accumulator adjustment programs, when someone uses a copay card, the portion that the manufacturer pays to the insurer does not get applied to their deductible or out-of-pocket costs.

For Jada, she pays $25.00 of the total cost for her medication at the pharmacy, using the copay card to pay the other $175.00. Her insurance sees that she paid for the medication, but wait! The insurance company knows she used a copay card. While the insurer receives the payments in full (from the insurer and Jada), rather than applying the total $200, the insurance only applies $25.00 to her deductible. 

Man with head in hands and question mark.

It Gets Worse

Unfortunately, accumulator adjustment programs are becoming reality for people right now. They go by many names: United Healthcare calls them “Coupon Adjustment: Benefit Plan Protection” programs, and Express Scripts calls them “Out of Pocket Protection” programs. 

Additionally, many insurance contracts already include language giving the insurance company the ability to do this. These programs are usually already within insurance contracts, but until recently, PBMs and insurance plans were unable to determine whether a patient was using a copay card or not.

Now that the technology has improved and they are able to determine not only if a cost was paid, but how it was paid, they can change how they apply payments to deductibles and out-of-pocket obligations. 

What You Can Do

  1.  If you use copay cards, check your insurance plan to see about accumulators. (You can call your insurance company if you can’t find it in the contract.)
  2. Watch your Explanation of Benefits notifications that you receive from your insurer. If you use a copay card, you should see quickly whether or not the copay card payment is being applied to the deductible.
  3. It’s important you know when you’ll meet your deductible so that you aren’t surprised.

Do you know if your insurance program uses an accumulator adjustment program?

California Makes Moves to Ban PBM Gag Clauses on Pharmacists

California’s legislature is entertaining a bill that would, among other things, prevent pharmacy benefit managers from imposing gag clauses on pharmacists.

AB-315 amends the Health and Safety Code to include certain requirements for pharmacy benefit managers, or PBMs. Among the requirements is a ban on gag clauses in contracts with pharmacists (Sec. 152152(a)(1)). The bill was introduced in February of 2017, and gained momentum throughout the year. The bill is currently in the inactive file, but could be brought out of inactive status at any time.

Pharmacy benefit managers can tell your pharmacist what to say – and it could cost you money.

A doctor's hands in handcuffs.

Currently, some pharmacists are not able to tell patients when they could be paying less for their medications because PBMs put gag clauses in their contracts. PBMs sometimes set the copay price of a drug (what you pay if you used insurance) higher than the list price of the drug (the price you pay without using insurance). When insurance companies do this price setting, it is called a “clawback.” Gag clauses order a pharmacist not to tell you about the clawback, so they cannot say if you could pay less for a drug if you did not use your insurance. This results in higher prices for the patient. This practice is especially detrimental for people with diabetes because they pay about 2.3 times more on healthcare than people without diabetes. Gag clauses are surprisingly widespread; some independent pharmacists estimate that if they were allowed, they could have saved their patients money in about 10% of transactions. DPAC has done a deep dive into gag clauses on our blog.

We need Californians to speak up! Tell the legislature that you don’t want PBMs telling your pharmacist what they can and cannot say!

 

Click here to send a letter to the California Assembly asking them to support AB-315!

Pharmacy Benefit Manager (PBM) Gag Clauses Tie Pharmacists’ Hands

Your pharmacist’s hands may be tied when it comes to telling you drug prices.

Gag clauses in contracts with pharmacy benefit managers (PBMs) prevent pharmacists from telling the truth about the price of some medications.

Currently, patients cannot rely on their pharmacist to give them all available information because PBMs are able to issue gag clauses within their contracts with pharmacies. The result of these gag clauses is higher costs for the unknowing patient. This problem is particularly egregious for people with diabetes, who pay about 2.3 times more on healthcare than people without diabetes. Contractually mandated gag clauses for pharmacists must be banned so that pharmacists are able to do their jobs and patients are able to trust their providers.

Three men wearing suits with their arms crossed.

The problem arises when PBMs engage in clawbacks.

Clawbacks occur when PBMs, standing in for insurance companies, set the copay price of a prescription drug higher than the cash price of that drug. When the patient goes to the pharmacy to purchase their prescription medicine, they pay their copay price, believing that they are getting a good deal through their insurance. In actuality, they may be better off skipping their insurance and paying the list price. The pharmacist knows the two prices, but is prevented from telling the patient that they are being ripped off because of gag clauses in PBM contracts.

Many pharmacists are bound by these gag rules, and there are many lost opportunities to inform patients of their pricing options.

According to a survey by the National Community Pharmacists Assn., 59% of independent pharmacists said they were subject to gag clauses prohibiting them from volunteering pricing information. The survey also revealed that 83% of pharmacists said there were at least 10 times during the past month when patients could have saved money if the pharmacists were allowed to tell them about the price difference. Some pharmacists estimate clawbacks happen in 10% of their transactions.

A doctor holding a heart and a businessman holding money.

Gag clauses are not always explicit, but always restrict pharmacists from telling their patients the whole truth.

Some contracts between PBMs and pharmacists explicitly bar the pharmacist from publicly criticizing benefit managers or suggesting customers obtain the medication cheaper by paying out of pocket. But even if the contract does not explicitly say that the pharmacist may not discuss lower priced options with their patients, it may include language that has the same effect. In one OptumRX provider manual, there is language that requires the pharmacist to charge their customers using their insurance the required copay “and only this amount.” Waiving the copay is “strictly prohibited.” And pharmacists who contracted with OptumRX in 2017 could lose their contract for many reasons, including engaging in “actions detrimental to the provider network,” doing anything that “disparages” it, or trying to “steer” customers to other coverage or discounted plans. Why would a pharmacist agree to such terms? Pharmacists are often forced into contracts with gag clauses because they need to serve people with insurance in order to stay competitive and retain customers. PBMs rarely negotiate with pharmacists, and the contracts PBMs offer are usually take-it-or-leave-it contracts. If a pharmacists refuses to sign the contract because it includes a gag order, the PBM will simply take its business to the next pharmacy in town.

State and federal governments are taking action to protect patient-constituents from deceitful gag clauses imposed on pharmacists.

Many states have outlawed clawbacks all together or have prohibited gag clauses for pharmacists. The Federal government is taking notice as well, with bills presented in the Senate and the House. In the Senate, the Patient Right to Know Drug Prices Act, or S. 2554, would ban the practice of pharmacy gag clauses. 

In a press release, bill sponsor Senator Collins said:

“Multiple reports have exposed how this egregious practice has harmed consumers, such as one customer who used his insurance to pay $129 for a drug when he could have paid $18 out of pocket… Americans have the right to know which payment method — insurance or cash — would provide the most savings when purchasing prescription drugs. By prohibiting gag clauses, our legislation would take concrete action to lower the cost of prescription drugs, saving consumers money.”

Thouse House bill, introduced by Representative Earl “Buddy” Carter, is called the Prescription Transparency Act or H.R. 5343. Rep. Carter is a pharmacist by trade, and said this about his proposed legislation:

“As a pharmacist for more than 30 years, there were many times when I was prevented from telling my patients that there was a cheaper option because of a gag clause. There is no reason pharmacists should not be able to talk to patients about what is best for them.”

The total cost of diabetes in 2012 was $245 billion, and 18% of that cost ($44.1 billion) was attributed to prescription medications. People with diabetes should not have to pay more for their medications simply because they did not ask the right questions.

Send a letter to your representatives asking them to co-sponsor legislation to prohibit gag clauses so you can trust that your pharmacist can tell you the whole truth!

Send a letter to your Senators

Send a letter to your Representative

A doctor's hands holding a stethoscope and handcuffed.

 

How an Idea Becomes a State Law

Have you ever thought to yourself, “there ought to be a law about that”? Working to get state laws introduced, passed, and signed is an important part of diabetes advocacy, especially now that states are taking a very active role in healthcare. Here’s a look through the whole process, from idea to law!

Refining Your Idea

A lightbulb crashing through a wall

Having the idea to make something a state law is usually the easiest part of the process. Even if you don’t have an idea you feel strongly about yourself, there are tons of people out there trying to get their ideas put into law. Find one you feel passionate about, and you’re on your way! Here are some good questions to ask yourself when coming up with and refining your idea: 

  • Can the state government pass this law?
  • Which government agencies would need to be involved?
  • Does the law simply require authorization (something that allows a change in the law and then orders an agency to implement it) or would it require appropriation (needs money to pay for implementation)?

Getting to Know the Political Landscape

Additionally, you must get involved in the actual politics needed to pass their proposed law. Has anything like it been introduced in the state? How did each party or legislator vote on it? Once you’ve researched these questions, you’ll get a better idea of the political landscape with regard to your particular issue. Every bill has to have sponsors, so the best plan of attack is to find state representatives who are willing to take on this particular cause.

Lobbying for Your Cause

Lobbying has a bad reputation, but activist lobbying simply is talking to others about a subject you’re passionate about and trying to get them to understand your position. Nothing nefarious about it! A bill requires one sponsor from the House and one from the Senate, so you will need to make sure there are multiple parties in the legislature willing to introduce the bill. Once a bill has been introduced, you can advocate for it by joining with professional lobbyists, community organizations, and/or party leadership to promote it to the public. Proponents of the bill can also work individually on many of the same actions: calling voters to spread awareness, calling legislators to express support, knocking on doors with educational information on the bill, etc.

The Lawmaking Process

Definition of the word "law"

For this section, we’re going to generalize a bit. We can do that because, out of 99 total legislative chambers in the United States, 70 use the guide Mason’s Manual of Legislative Procedure. The other 13 use either Jefferson’s Manual or Robert’s Rules of Order. Because the vast majority of legislatures are structured similarly, the process for law creation can be generalized. Some legislatures use a shorter version for their particular processes, but the following steps are usually involved in each state legislative body. BUT make sure you’re following the right steps for your legislature before charging ahead! 

Bill Introduction

Bills can be introduced in either the state house of representatives or the senate. They must be sponsored by a senator and a representative. Bills are assigned an identification number upon introduction that citizens can use to track progress.

Committee Procedure

It’s hard to get a big group of people to decide on things, right? That holds true in state legislatures. Because the legislatures are so large, the majority of state government operations are through committees. Each committee is specialized to consider bills on a particular topic, so it’s important for you to identify the committee that works on the issue you are passionate about. Committees recommend bills they think are important to move on in the legislative process.

Reports of Committee

After a committee is finished working on a bill and has recommended it for further consideration, it refers the bill to the state house or senate during the reports of committee section of daily business. If a bill is reported, it is given a second reading by the larger group and put on the schedule. State legislature websites usually have daily schedules, and bills that have been reported positively by committees will be listed with a date and time for consideration by the entire house or entire senate.

Definition of the word 'legislation"

Third Reading

Once a bill gets on the calendar, it is considered at a third reading. The third reading is considered by all members of the house or senate, at which point members can study the bill in detail, debate, and amend it. If the majority vote in favor to pass the bill, it moves on to the next phase.

Transmission to the Other Chamber

If a bill passes when heard by the house of representatives or the senate, it is formally transmitted to the other chamber for consideration (if it’s been heard by the house of representatives, it’ll be passed to the senate, and vice-versa). Then the ‘new’ chamber goes through the same process as the one that’s already done the work. If the chamber receiving it does not report it from the committee it falls under, or does not consider it with the entire chamber, the bill fails. If the receiving chamber goes through the same process as the first chamber and the bill moves through each stage into the third reading, the bill is returned to the original chamber, usually with amendments. There are several ways a bill can move after this:

  • If the original chamber concurs with the amended bill, it is ready for enrollment.
  • If the original chamber does not concur with the amendments, the bill fails.
  • If the original chamber does not concur with the amendments but requests a conference committee, one such committee is appointed. Each chamber appoints members to the committee and the process continues.

Conference Committees

A conference committee works with both chambers’ versions of a bill and tries to compromise to create a single final bill. If an agreement is made, the bill passes and moves on to the governor. If one chamber refuses to adopt the report of the conference committee, further conference can be ordered, or a new conference can be appointed. If no agreement is made before the legislative session ends, the bill fails.

legal books

Presentation to Governor

Once an identical bill has passed in both chambers, it goes to the governor’s desk for consideration. The governor may sign it, which enacts the bill into law. A governor may also veto the bill, at which point he/she returns it to the original chamber with an explanation. The bill is then reconsidered (usually with suggestions for amendments by the governor) and returned to the governor if both chambers approve of the changes.

Reacting to a Veto

Another option is for a majority of each chambers’ members to approve a veto bill in the form passed by the legislature, which overrides the governor’s veto and enacts the bill into law. If a governor does not return the bill to a legislative chamber within a certain number of days after presentation, it becomes law without his/her signature. Finally, if a bill reaches the governor a certain number of days before the legislative session ends, the governor has the opportunity to veto after session adjournment. This is a pocket veto, and a very final veto, as the legislature has no chance to reconsider it.

a hand drawing a lightbulb

Revisiting Your Idea

That’s a lot of steps. We get it. It’s easy to look at that process and think that your idea will never make it through. But think about all that has come before – both good laws and bad ones – and consider that at one point, they were an idea in someone’s head. You can make it!

Even if your idea does not become a state law, think about the other impacts you could have. Throughout this entire process, you’ll meet people you can convince to care about diabetes issues. You’ll bring awareness to your idea. And you’ll work hard to make your views known, which is so fulfilling. Having your idea become a state law can change so much for so many, and even if it doesn’t make it all the way through to become a law, it can change the entire community!

What ideas do you have for your state legislature? Feel free to comment below!

Advocacy 101: Writing an Effective Op-Ed

Extra! Extra! Read all about it!

When well written, op-eds can be wildly successful at convincing people to take action on a certain diabetes issue. This blog post will show you how to write an op-ed that will encourage people to advocate for your solution!

Op-eds are commentary articles from readers of a particular news source. A good advocacy op-ed outlines a problem and then suggests a way to fix it (kind of like what we do at DPAC!). There’s a formula for writing op-eds:

  1. Opening = outline the problem and say how to fix it
  2. Middle = your opinion with supporting facts
  3. End = restate the problem and call on the reader to act!

Writing the Opening

Hands on a desk writing on a pad of paper.

A good opening does three things: it clearly states the problem, shows how the problem is relevant, and provides a suggestion to fix it. You can do all that in just three sentences!

For example, you can show relevancy by tying the issue to something in the current news. Stating the problem should be easy- it’s what made you want to write the op-ed in the first place! Then all you have to do is write how you’d like someone to fix it. This can be by writing a letter of their own, calling their state or federal representatives, or any other action that will help solve the problem.

Here’s an example opening: (Relevancy →) On April 1, Medicare rolled out a new program for beneficiaries, the Medicare Diabetes Prevention Program, which is designed to help beneficiaries who have prediabetes avoid being diagnosed with diabetes through education and lifestyle changes. (Problem →)However, many potential beneficiaries do not even know if they have prediabetes. (Solution →) Physicians should screen their patients for prediabetes to ensure that the patients know about what treatment options are available.

Writing the Middle

The middle should be three paragraphs of information. Lead with your opinion, then back up your opinion with objective facts. Don’t only use opinion or only use facts because it is the mixture of the two that best convinces people to see your side. Plus, even if someone disagrees with you, they cannot disagree with facts.

Here’s an example of a middle paragraph: (Opinion →)Doctors should test their patients for prediabetes so that eligible patients can receive treatments like the Medicare Diabetes Prevention Program. (Facts →) According to the CDC, at least 23 million people age 65 and older have prediabetes. Unfortunately, about nine out of ten people who have prediabetes do not know they have it. Without treatment, prediabetes can lead to a diabetes diagnosis, and all the lifestyle changes, medication, and inappropriate stigma that comes with it.

Writing the End

After you’ve written all that in the middle, you should get to the point quickly in the end. After all, if they’re still reading, you’ve gotten their attention- now make them work! Your ending should be two sentences; the first one restates your solution, and the second one issues a call to action. The call to action should be something people can do. Asking people just to support your view doesn’t cause enough change.

Here’s an example of the ending: (Solution →) If physicians test their patients for prediabetes, then the patient can engage in programs like the Medicare Diabetes Prevention Program that may help them avoid a diagnosis of diabetes later. (Call to Action →) Sign this letter to the physician’s group asking them to pay more attention to prediabetes!

Tips and Tricks

Hopefully we’ve made it very simple for you. Here’s a couple bonus tips to make your op-ed extra special:

Newspapers that say 'breaking news'

  1. It’s tempting to write your story and ask people to empathize with you. You can do that, but make sure you back up your experiences with facts! An op-ed shouldn’t just be a way to complain!
  2. Try to shoot for 750 words in your op-ed. Editors usually look for at least 500 words and no more than 1200. (However, some newspapers and online news outlets have a limit of 300 words or less, so make sure you check to see the word count – and then make those words count!)
  3. Remember, your audience is not just the people reading the final product, but also the editor who will decide if the op-ed gets published.
  4. Focus on only one issue. You can always write another one for other issues!
  5. Write how you talk. If you wouldn’t say it in real life, avoid it in your writing. The key is to be personable, but not chatty. Read some op-eds in trusted news sources to get a feel for the language.
  6. Have confidence in your writing! Your passion for diabetes advocacy will shine through!

What Next?

Go forth and write! The easiest way to get good at writing op-eds is to practice.  And there are plenty of diabetes issues on which to advocate.

Here’s an issue that everyone can be concerned with, whether you’re on Medicare now or plan to be someday: seniors on Medicare who use CGM are not allowed to view their data on a smartphone, which means they can’t use the Dexcom Follow app to have their loved ones view their data and get alarms when they have high or low blood sugars. It’s a huge safety issue!

If you choose to write on this issue, feel free to call your readers to visit the DPAC website and have them send a letter to the Representatives asking them to make CMS justify their decision to put beneficiaries at risk. Read more and get writing!

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