LIMIT STEP THERAPY (H 4929)

By Bob Katzen

The House 153-0, approved and sent to the Senate a bill that limits the use of health care plan mandated prescription drug “step therapy” protocols and provides more exemptions to the mandate. Step therapy requires the patient to try less expensive options before “stepping up” to drugs that cost more.

“This is a great bill for patients,” said Health Care Financing Committee chair John Lawn (D-Watertown). “This legislation balances the need to manage utilization and control costs of expensive treatments with the moral imperative to protect patients who need life-saving treatments. Thanks to this bill, patients will get the right drug at the right time without delay.”

“A top priority of the House is to ensure that every resident of the commonwealth has access to quality, affordable health care, but controlling costs should never come at the expense of positive patient outcomes,” said House Speaker Ron Mariano (D-Quincy). “This legislation helps to achieve that goal by ensuring that patients in Massachusetts can circumvent step therapy protocols in instances where the process will result in delayed access to the only adequate medication.

Conditions which would exempt a patient from trying the less expensive drug first include if the treatment will harm the patient, or if the patient previously tried the required treatment, or similar treatment, and it was ineffective.

(A “Yes” vote is for the bill).

Rep. Christine Barber Yes Rep. Mike Connolly Yes Rep. Erika Uyterhoeven Yes

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