Healthy People 2030

January 17th,2019

Alex Azar, JD Secretary, U.S.Department of Health and Human Services 330 C Street SWWashington, DC 20416Re: Public Comment for Healthy People 2030Comments submitted via emailto [email protected] Secretary Azar, The Global Healthy Living Foundation (GHLF) appreciates the opportunity to provide comments for Healthy People 2030. GHLF is a 20-year-old 501(c)(3) patient organization representing chronically ill patients and their caregivers across the country. We workto improve the quality of life for patients living with chronic disease by making sure their voices are heard and advocating for improved access to care at the community level. The patientswe representsuffer from chronic conditions including arthritis, psoriasis, gastrointestinal disease, cardiovascular disease and migraine. GHLF commends the Department of Health and Human Services (HHS) fortheir work tosetthe objectives included for Healthy People 2030. We are specifically encouraged byand supportthe objectives set for arthritis, osteoporosis, and chronic back conditions(Objectives AOCBC-2030-01 through AOCBC-2030-07 and AOCBC-2030-D01), as well as those outlinedinthe Access to Health Servicessection(Objectives AHS-2030-01 through AHS-2030-09 and AHS-2030-R01 throughAHS-2030-R02).In particular with regards to the goals set for arthritis, we applaud HHS forretaining theobjective ofreducing“the proportion of adults with provider-diagnosed arthritis who are limited in their ability to work for pay due to arthritis.” (AOCBC-2030-03)We find that patients eagerly seek treatment with the hopethat can, in part,get back to work as soon as possible.They hope to provide themselves and their families with financial security despite their struggle with a debilitating disease. However, we also findthat feelings of isolation and depression can have a significant impact on a patient’s health outcomewhen apatientisforced to stop working due to their disability.Setting the goal of reducing the prevalence of this situation should be a high priority and we would like to see the Department engagein all possible efforts to see that this goal isreached.GHLF also strongly supports the developmental objective of “increasing self-management of high impact chronic pain.” (AOCBC-2030-07) When patients are able to successfully self-manage their disease,theyoftenexperiencereduced health expensesand increasedself-confidencedue totheir ability to controltheir condition.Regardingthe objectives outlined for Access to Health Services, GHLF strongly supports the goal of reducing the proportion of patients who are unable to obtain or experience delays in obtaining necessary medical care. (AHS-2030-05)Oftentimes, patients are forced into hazardous Page2situationsbecause of insurance protocols like step therapy or prior authorization that delay their access to treatment deemed necessary by their physicians. Thisdelaycan lead to harmfulconsequences, prolonging pain, symptoms and, in many cases, a cure. Step therapy can resultin poor adherenceand delay improved patientoutcomes.Eliminating or reducing this delay by implementing patient-focused reforms of utilization-management protocols is somethingwe have advocated at the state and federal level.We are very happy to see that HHS continues tomakethis a core objective for Healthy People 2030and urges the Department to consider the impact of utilization-management protocols as you strive to meet this goal. GHLFsupportsthe use of real-world data to provide additional evidence on safety and effectiveness as you try to reach these objectives. Patient reportedoutcomesconstitute a powerfulsource of real-world data that should be usedas endpointsto assess Healthy People 2030 goals. Our 17,000-member patient registry, ArthritisPower, allows patients to actively engage in health research while monitoring their own progress in collaboration with their physicians. Our primary mission is to provide patient-reported data to researchers interested in understanding how patients respond to treatments over time. Often, the data collected by researchers does not reflect outcomes that matter most to patients. We would welcome the opportunity to sharepatient-generated datawithHHS to help evaluate the progress of the HealthyPeople 2030 goals.GHLF commends HHSfor its continued commitment to patient centeredness. We look forward to working with HHSon achieving these objectivesand hope you will view GHLF as a resource and partner moving forward. If you have any questions about our comments, please feel free tocontact meat [email protected] submitted,Steven NewmarkDirector of Policy and General CounselGlobal Healthy Living Foundation