If you battle a chronic condition, you have likely experienced step therapy practices firsthand.
Step therapy, also known as “fail first,” occurs when your doctor prescribes a specific medication to treat and manage your condition, but your insurer requires you to try and “fail” on cheaper medications before covering the medication originally prescribed by your doctor. This harmful, shortsighted practice allows insurers to cut costs at the patient’s expense. Without access to the treatment prescribed by their doctor, patients may experience setbacks in their condition, leading to higher health care costs in the future.
The Chronic Disease Coalition is involved and largely supportive of the step therapy reform efforts at the state and federal levels. Legislation in various states including, Ohio, Massachusetts, Pennsylvania, Minnesota and others, would ensure patients have access to the medication that is prescribed by their doctor.
Most recently, the Minnesota legislature unanimously passed H.B. 3196, which allows doctors to override step therapy requirements and prescribe effective medication for the patient’s condition.
“By preserving the doctor-patient relationship, insurers will no longer be able to play doctor and determine the medication a patient should access,” explained Scott Bruun, executive director of the Chronic Disease Coalition in a letter to the editor.
The Chronic Disease Coalition commends Rep. Kelly Fenton and the Minnesota legislature for its diligence in passing legislation that protects patients from greedy insurance practices. While organizations, advocates and patients take the time to celebrate this success, we recognize that more needs to be done to protect patients from discriminatory insurance practices. Join us and become a part of the fight to ensure all patients have access to care.
To read Bruun’s full letter, click here.