The Veterans Health Administration has a new opportunity to show their support for veterans who suffer from hereditary ATTR amyloidosis. It could dismantle the obstacle course of restrictions that keep veterans from accessing the most appropriate treatment to fight their rare, complex and still incurable disease.
And what better time than Veterans Day to get started?
Slow Walking Access to the Newest Drug
In a win for patients, the FDA recently approved vutrisiran as a subcutaneous injection for the treatment of hATTR amyloidosis neuropathy, a manifestation of the condition that attacks the nervous system.
The VA followed suit, stating it would cover the medication – only after patients try tafamadis for six months and find it ineffective. It’s a fool’s errand though, because tafamidis is specifically approved for hATTR amyloidosis cardiomyopathy, a manifestation of the disease that causes cardiac problems.
While both drugs treat hATTR amyloidosis, that’s where the similarities stop. They are designed to address distinct symptoms caused by different presentations of the condition that is caused by a build-up of abnormal proteins in the body.
Utilization Management Must Go
While the VA’s step therapy requirement for vutrisiran is frustrating, it’s not the first time the payer has restricted access to an on-label neuropathy medication. In fact, the VA has maintained similar policies for the full range of amyloidosis treatments for multiple years.
But these delays happen at the cost of patients’ health and well-being. The median survival rate for untreated hATTR amyloidosis neuropathy is just 2.5 years after diagnosis, which makes timely access to the most appropriate medication so important. Allowing the disease to progress unchecked can cause irreversible damage to the nervous system and worsen patients’ quality of life.
And the “fail first” policies for accessing neuropathy medications aren’t the only administrative barrier VA-insured veterans face when seeking treatment. Other amyloidosis treatment challenges include:
- Restrictive medication rules, which permit access to only lower dosages than those recommended by the FDA for certain medications.
- High co-payments, which can make some treatments unaffordable.
- Inconsistent policies from region to region, which has the effect of sending veterans shopping for a facility willing to provide the access they need.
America must do better. Those who fought for the country deserve broad support in their fight against amyloidosis. At a minimum, they should have uncomplicated and affordable access to the most appropriate treatment for their type of the condition.