Donna Sweet: Step Therapy Bill Delays Access To The Best Care


Over 30 years ago, I decided to focus my career on caring for those suffering from HIV and AIDS. While HIV was considered a death sentence in 1981, it is now, for the most part, a controlled and treatable chronic condition – made possible only with the right medications. Today, an HIV patient’s lifespan can be the same as someone of the same age without HIV. The science of treating HIV is nearly a miracle.


I have cared for thousands of HIV-infected patients, and each individual requires a personalized treatment protocol that takes into account a patient’s size and gender, treatment history, viral resistance, coexisting illnesses, other medications, immune status and the side effects that a particular drug may cause, among other factors.


Shockingly, there is a bill being considered in Kansas that will take away a doctor’s ability to consider these factors when prescribing drugs to their patients. Senate Bill 341 (SB 341) will remove step therapy protections for Medicaid patients across Kansas – restricting doctors in their medical decisions.


Step therapy, commonly referred to as the “fail first” method, is the process by which patients are required to try – and fail – on at least one or more alternative prescription drugs chosen by the insurance company before coverage is granted for the drug originally prescribed by the health care provider. This is used by health plans to control costs; however, it has shown to have a very negative impact on patients.


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The Wichita Eagle        Published on April 18, 2016

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