STEP THERAPY

By Bob Katzen

The Senate 38-0, approved a bill that would limit the use of health care plan mandated prescription drug “step therapy” protocols and provide more exemptions to the mandate. Step therapy requires the patient to try less expensive options before “stepping up” to drugs that cost more. The House has approved a different version of the measure and the Senate version now goes to the House for consideration.

“Patients with complicated illnesses should be receiving the medications that their doctors know they need—not repeatedly taking medications that they know to be ineffective just to help save on costs in the near-term,” said sponsor Sen. Julian Cyr (D-Truro), Senate Chair of the Committee on Mental Health, Substance Abuse and Recovery. “Waiting for treatment to fail first before utilizing a preferred medication often leads to worsening symptoms that cause complications and needless suffering for patients. It is a shortsighted practice that puts patients at unnecessary risk. Step therapy takes lower costs today in exchange for more harm, more hospitalizations and more spending in the very near future.”

“Reforming the insurance-mandated practice of step therapy is long overdue,” said Sen. Cindy Friedman (D-Arlington), Senate Chair of the Committee on Health Care Financing. “Step therapy or ‘fail first’ protocols too often direct patients to cheaper medications rather than those more suitable to treat their condition. With this legislation, we will join over half the states in the country reforming these practices, putting the focus back on health care providers working with patients to offer the best treatment possible.”

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