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Home / Driving Policy / The Rare Disease State Report Card
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How does your state measure up?

Select your state to learn more:

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Patient Stories

    • Tammy, Arkansas

      Step Therapy

      Step therapy has been a big challenge for my family. Just this year, three of my immediate family members were taken off medications that were working very well and were required to try other, less expensive medications. Why change what is working and unsettle patients’ quality of life? Step therapy should not be used for patients who are already stable on a medication that is effective for them.

    • Pat, New Jersey

      Medical Nutrition

      My seven-year-old daughter, Kinsley, has digestive issues and is no longer able to eat by mouth or accept feeds through G- or J-tube access. She has been dependent on total parental nutrition (TPN) for almost four years, but it is critical to try to keep her stomach moving to prevent any damage. Her physicians have prescribed her 5mL of Pedialyte to be administered by the enteral feeding pump, at the cost of $700. Insurance denied coverage, stating patients must take in at least 25 mL per hour in order to qualify. Her fragile system cannot handle a higher volume, as her multiple medical specialists have testified. Rare disease patients must have their prescriptions and nutritional products covered appropriately without delay, so that patients do not regress.

    • Nick, Tennessee

      Newborn Screening

      My four-year-old and eleven-month-old daughters were both screened at birth. Both girls were found to have elevated levels of phenylalanine and diagnosed with phenylketonuria (PKU). Fortunately, their cases are mild and treatable with medication. Thanks to early screening and continued monitoring, we can keep the phenylalanine levels low and controlled without any developmental or other health issues.

      Out-of-Pocket Costs

      My previous employer’s health benefit plan lacked adequate coverage for the medication my daughter requires to treat her metabolic condition, phenylketonuria (PKU). By mid-2018 we had used up all funds on our co-pay card and we were at risk of having to find another way to cover the high cost of our daughter’s medication. NORD provided assistance to bridge the gap, which allowed us to keep my daughter’s prescription filled through the remainder of that year. Today, I’ve changed employment and my current company covers the medication appropriately.

    • Mike, California

      Newborn Screening

      I have two boys who were diagnosed with a rare genetic disease called mucopolysaccharidosis type II (MPS II, aka Hunter syndrome). My sons were diagnosed around the same time, at the ages of four and one respectively. Nine years after starting treatment, the younger one, who began treatment at a younger age (thanks to his brother’s diagnosis), is faring far better than his elder brother in many ways. The most likely reason for this is his early treatment. Imagine if they had both been diagnosed as newborns and treated immediately.

    • Maria, Illinois

      Out-of-Pocket Costs

      As a cystic fibrosis patient, I am currently prescribed over 20 medications. Each needs to be filled through one mail order pharmacy, otherwise my insurance plan will not help cover the cost. Each medication is organized by tier pricing ranging from $15 – $30. My current out-of-pocket cost for a month of medications is roughly $400. This is a financial strain on my family at times because I am on disability income.

    • Kenny, West Virginia

      Rare Disease Advisory Councils

      I have been advocating for Rare Disease Advisory Council legislation in West Virginia since 2016. In 2020, we finally completed the process. The RDAC effort took the collective work of advocates, organizations and legislators. I am very excited to report that the West Virginia RDAC was passed unanimously in both legislative chambers – there was not one single ‘NAY’ vote. The RDAC was signed by the Governor and officially became law in July.

    • Jennifer, Kentucky

      Medical Nutrition

      I have several complex medical issues and require medical nutrition as part of my treatment. I have often found that insurance does not cover the cheaper and less invasive treatment option. My physicians wanted me on three to four nutritional drinks a day, consumed orally, but insurance would not cover this cost. Insurance would, however, cover the cost of a permanent feeding tube and supplies, as well as hospitalizations due to complications from the feeding tube.

    • Jana, Virginia

      Newborn Screening
      From just looking at my son, 22, and daughter, 17, who both have isovaleric academia, the profound impact of newborn screening on my family and our children’s lives is obvious. Their lives parallel one another only with the close management of their disorder by their specialists. Stephen’s late diagnosis at age three and a half due to lack of NBS altered his normal life to one with severe disabilities and complex medical issues. Caroline, on the other hand, was screened early and lives a normal, healthy life fulfilling her dream as an equestrian. Stephen and Caroline represent why newborn screening is so critical for every baby.

      Medical Nutrition
      My son Stephen and daughter Caroline both have an inborn error of metabolism whose treatment includes a medical formula that restricts a specific amino acid in their diet. While costly, it is imperative that they have access to this specialized treatment. Medical nutrition has enabled them to grow, develop and remain metabolically stable, and it must be covered by insurance.

    • Erica, Minnesota

      Newborn Screening

      When my daughter Chloe was diagnosed with metachromatic leukodystrophy (MLD), doctors had to rely on the signs and symptoms of the disease to make the diagnosis. But as MLD is an aggressive neurodegenerative disorder, it is crucial that children be diagnosed before symptoms appear in order to have any chance of stopping its progression. Chloe passed away from the

      disease and for me, newborn screening represents these children’s only hope for identifying this genetic disorder in time to intervene. Advocating for newborn screening gives me a chance to rewrite the ending to the story of diagnosis and treatment for children like my daughter.

    • Danyelle, Wisconsin

      Newborn Screening

      Both of our children were diagnosed with spinal muscular atrophy (SMA) in 2013. While they are both doing well, we know that early detection and treatment of SMA results in the ability to prevent loss of strength instead of having to try to rebuild what has already been lost. It’s important to me that other families not have to wait months, or even years, for a diagnosis, all while watching their child lose strength. Newborn screening can allow families time to process and prepare for next steps after a life-changing diagnosis.

    • Charlene, Ohio

      Rare Disease Advisory Councils

      Ohio has recently passed legislation to establish a Rare Disease Advisory Council. Working with other organizations has been very rewarding. Ohioans with a rare disease finally have a voice at the state level on policies and legislations that may impact them.

    • Anne, Florida

      Newborn Screening

      Knowledge is power! My son passed away from a rare neurologic disease, and when my daughter was tested at birth, we learned she had the same condition her brother was born with. Thanks to newborn screening, my daughter was able to receive treatment in her first month to stabilize the disease and have a much greater quality of life. Early interventions save lives.

NORD State Report Card

Since its inception in 1983, the National Organization for Rare Disorders (NORD®) has worked to ensure that the voices of those living with a rare disease are front and center when federal and state governments are making important policy and regulatory decisions.

In 2015, NORD launched its State Report Card with the goal of evaluating how effectively states are serving people with rare diseases and giving our rare disease community a useful tool to help advocate for necessary changes. It is important to note the issues contained here in touch on several critical and relevant policy areas at the state level, but the nine issues evaluated within this report card are not exhaustive and there are many others that impact the lives of rare disease patients.

The latest edition of the State Report Card was compiled using data current as of November 2024. NORD hopes the State Report Card can serve as a tool for patients, advocates, and policymakers as they strive to advocate for state policies to best serve the needs of the rare disease community.

The Issues

Click to learn more:

NORD RDAC Icon Language photo.

Medicaid Financial Eligibility

NORD RDAC Icon Language logo image.

Medical Nutrition

NORD RDAC Icon Language logo image.

Newborn Screening

NORD RDAC Icon Language logo design.

Protecting Patients in
State Medicaid Programs

NORD RDAC Icon Language logo image.

Protecting Patients in
State-Regulated Insurance

NORD RDAC Icon Language logo design.

Rare Disease Advisory Councils

NORD RDAC Icon Language logo image.

Step Therapy (Fail First)

NORD RDAC Icon Language logo image.

Telehealth

NORD RDAC Icon Language logo design.

Prescription Drug
Out-of-Pocket Costs

NORD RDAC Icon Language photo.

Medicaid Financial Eligibility

NORD RDAC Icon Language logo image.

Medical Nutrition

NORD RDAC Icon Language logo image.

Newborn Screening

NORD RDAC Icon Language logo design.

Protecting Patients in
State Medicaid Programs

NORD RDAC Icon Language logo image.

Protecting Patients in
State-Regulated Insurance

NORD RDAC Icon Language logo design.

Rare Disease Advisory Councils

NORD RDAC Icon Language logo image.

Step Therapy (Fail First)

NORD RDAC Icon Language logo image.

Telehealth

NORD RDAC Icon Language logo design.

Prescription Drug
Out-of-Pocket Costs

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