It was an honor to be recognized as the National MS Society legislator of the year for 2018. This recognition was due to our work on the Step Therapy Bill this past year. This was a bill that many of our partners came together on to create a policy that will improve the lives of those that have long-term diseases that are treatable but not curable.
Step Therapy is a severe and unnecessary barrier to patients getting treatment, requires a “fail first” approach on the medications that the Doctor and the patient know won’t work. Under Step Therapy a patient may be required to try one or more alternative prescription drugs before coverage is granted for the medication prescribed by the patient’s health care provider.
The insurance company essentially determines the patient’s treatment plan based solely on what drugs they can get for the best price. The patient’s other health conditions, medications, concerns about drug side effects, and the severity of disease were previously not considered.
There are additional circumstances under which patients should be exempted from Step Therapy protocols. This includes situations when a required drug has been tried and failed previously, or the patient is already stable on another medication. Physicians should also have the authority to request an override of the Step Therapy protocols based on a patient’s medical condition and history and should be able to conduct their practice with what they deem to be the best treatment for their patients.
This bill did not eliminate the Step Therapy protocol but made it a more workable and patient-focused process, but the reform definitely will have an impact, and many Minnesotans will be healthier as a result.
