As a physician, I make decisions in partnership with patients, taking each person’s medical history and needs into account. But insurance companies often use other tactics to override my recommendations, putting patients in jeopardy.
Step therapy is when patients are required to try – and fail – on alternative prescription drugs chosen by insurers before coverage is granted for the drug originally prescribed. Used in an effort to control costs, it has shown to have a negative effect on patients and delays access to optimal treatments, often causing unnecessary suffering for the patient.
Step therapy legislation is currently at play on both sides of the border – HB 2029 in Missouri (which passed unanimously out of the Senate Veterans’ Affairs and Health Committee recently) deals with private insurance and adds protections against step therapy. SB 341 in Kansas deals with Medicaid and removes protections from step therapy.
Doctors, not insurers, know patients’ medical histories, which medications have worked and which haven’t and drugs that a patient might be sensitive to.
We need step therapy protections in place.
I urge people to contact their legislators and say no to step therapy. Physicians, along with their patients, should determine the best course of treatment.
Chief, Division of Specialty Medicine
Kansas City University of Medicine and Biosciences
The Kansas City Star Published on April 25, 2016