1. Arthritis Foundation Arthritis Ambassador Briefing September 11, 2013 3PM Eastern Dial In: 1-866-487-9460 Participant Code: 931 709 2991# Materials available for download at http://www.arthritis.org/ambassador_assignment.php

2. Agenda Welcome & August Recap – Laurie Markle, Manager Grassroots Advocacy Ambassador Experience– Hanna Gruen (PA-14) How Limiting Cost Sharing for Specialty Drugs would Impact Insurance Premiums- Maria Spencer, Director Federal Affairs September Ambassador Assignment– Laurie Markle Reporting Your Activity– Laurie Markle Housekeeping– Laurie Markle Q&A 1

3. August Recess Recap 2 CosponsorsAwareness Pass HR 1827

4. August Recess Recap 3 33 Congressional Meetings & Town Halls Results pending. Email to follow.

5. Ambassador Experience On the phone: Hanna Gruen, PA-14 Ambassador 4

6. HR 460 Impact on Premiums 5 The Problem: Health insurance companies are placing vital, life- changing and life-saving medications including biologics on specialty tiers and charging a co-insurance or percentage of the cost of the drug, instead of a copay. This practice is placing a substantial financial burden on patients. Some patients may pay hundreds or thousands of dollars per month for a medication that was traditionally on a fixed co-pay.

7. HR 460 Impact on Premiums 6 The Solution: The Patients’ Access to Treatments Act (H.R. 460): Requires plans to limit cost sharing requirements for specialty drug tiers to the level of cost sharing required for non-preferred brand drug tiers; there can be no more than a 10% difference in total dollar cost sharing for any drugs on a tier. Drug TypeExample Patient Out-of-Pocket Expense Tier 1: Generic$10 Tier 2: Preferred Brand Name$30 Tier 3: Nonpreferred Brand Name$50 (limits range to 10%: $50-55) Tier 4: Specialty Tier DrugCost sharing can be no greater than Tier 3 out of pocket expense.

8. HR 460 Impact on Premiums 7 Arthritis Foundation and 22 other organizations formed the Coalition for Accessible Treatments (CAT) in support of the Patients’ Access to Treatments Act (H.R. 460) CAT commissioned a study to address Congressional concerns about PATA’s impact on premiums. Study Conclusion: Limiting Specialty Drug Coinsurance does not have a large impact on premiums. The bill would increase premium costs by $3 per year, absent any other changes to the average benefit design.

9. HR 460 Impact on Premiums 8 What are we doing? CAT hosted a press conference to release study results Sept. 10 th CAT will host a Senate briefing Sept. 19 th Goal: gain additional co-sponsors in the House; Senate bill introduced

10. September Ambassador Assignment 9 SUNDAYMONDAYTUESDAYWEDNESDAYTHURSDAYFRIDAYSATURDAY 1234567 891011121314 15161718192021 22232425262728 2930 PRESS EVENT AMBASSADOR BRIEFING SENATE BRIEFING CALLS & EMAILS CALLS & EMALS CALLS & EMAILS CALLS & EMAILS CALLS & EMALS CALLS & EMAILS CALLS & EMAILS We need Senate Health Legislative Assistants at the Briefing on September 19 th!

11. September Ambassador Assignment 10 Call your Senate Health Legislative Assistants and request their attendance at the September 19 th Briefing If you leave a message and don’t hear back within 3 days, email them. Report POSITIVE RSVPs to Geoff Steber at gsteber@arthritis.org Report your activity to arthritis.org/report

12. September Assignment: First Steps 11 Identify your 2 Senators @ Senate.gov Visit your Senator’s website and identify their DC phone number @ bottom of page Call and ask to speak with the Health Legislative Assistant. Share prepared voicemail. Follow up with an email. If you don’t know the email address, email lkeivel@arthritis.org or lmarkle@arthritis.org

13. September Ambassador Assignment Accessing the resources you need www.arthritis.org/ambassador_assignment.php 12

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17. Reporting Your Activity POSTIVE RSVPs should be reported to Geoff Steber at gsteber@arthritis.orggsteber@arthritis.org Report your activity & receive credit at www.arthritis.org/report www.arthritis.org/report Username: Your email address Password: Last Name 16

18. Housekeeping Remaining Ambassador Briefings: October 2, 2013 @ 3PM Eastern November 6, 2013 @ 3PM Eastern Ambassador Awards are awarded annually based on activity reported October-October. 2013 Award recipients will be announced at the November 6 th briefing. 17