Step therapy, also referred to as “fail first,” requires a cancer patient to try a health plan preferred drug and have that drug fail them. (Representational Image: Wikimedia Commons) 
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Legislation Passed to Increase Access to Metastatic Cancer Treatments in Delaware

Step therapy, also referred to as “fail first,” requires a patient to try a health plan preferred drug and have that drug fail them

MBT Desk

The world’s leading breast cancer organization, issued the following statement on the passage of  HB 364, which expands the prohibition of step therapy protocols for metastatic cancer patients to further include associated conditions caused by the side effects of the patient’s cancer treatment. Step therapy, also referred to as “fail first,” requires a patient to first try a health plan preferred drug, have that drug fail them – meaning the treatment didn’t work for the patient – before they can use the treatment their provider prescribed. The legislation has been approved by the Delaware legislature and signed into law by Governor John Carney:

We thank the legislature and Governor Carney for eliminating insurance barriers so that metastatic cancer patients with state-regulated health plans receive immediate access to the most effective treatments from the start and will not to be forced to fail on an alternative treatment first.
Molly Guthrie, Vice President of Policy and Advocacy at Komen
Komen believes treatment decisions are most effectively made through a collaborative process involving patients and their providers, prioritizing individual needs and not based on harmful insurer policies.(Representational Image: Wikimedia Commons)

“Komen believes treatment decisions are most effectively made through a collaborative process involving patients and their providers, prioritizing individual needs and not based on harmful insurer policies. Unfortunately, most step therapy protocols rely on generalized information regarding patients and their treatments and don’t consider unique experiences, previous responses to treatments and any comorbidities.”

“Komen will continue to advocate for legislation that ensures fair and equitable access to high-quality breast care for all, no matter their age, race, ethnicity, sexual orientation, gender identity, cancer stage or socio-economic status.”

(Newswise/GP)

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