Susan G. Komen® Commends Bill Introduction; Urges Quick Passage
ANNAPOLIS – Susan G. Komen®, the world’s leading breast cancer organization, applauds Senator Dawn Gile and Delegates Harry Bhandari and Jamila Jaye Woods for introducing legislation, HB 1087/ SB 921, that would 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. This health plan technique is used in an attempt to control costs; despite evidence showing step therapy requirements often adversely impact a patient’s treatment and health outcomes. Although metastatic breast cancer cannot be cured, it can be treated. Treatments are highly personalized and must be based on the decisions between the patient and their health care providers in a timely manner.
“Treatment decisions, especially diseases like metastatic breast cancer where delays or deviations could be deadly, should never be dictated by arbitrary insurance protocols,” said Molly Guthrie, Vice President of Policy and Advocacy at Komen. “Cancer patients facing aggressive diseases should not be forced to fail on an alternative treatment before receiving the most effective treatments from the beginning,”
“SB 921 is about trusting our health providers with treatment decisions that are the best fit for their patients’ individual needs, rather than allowing insurers to override their medical advice with mandated one-size-fits-all treatments that can waste precious time for patients and their families,” said Sen. Gile.
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. Additionally, step therapy policies are particularly burdensome in oncology, given the individualized nature of modern cancer treatments. 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.
“Patients with metastatic cancer face critical time constraints and any additional delays in treatment could significantly jeopardize their lives,” said Del. Bhandari. “This bill ensues doctors – not insurance companies – decide the best treatment. Removing these barriers means faster, more effective care for Marylanders fighting for their lives.”
“The Legislation provides Marylanders battling metastatic cancer peace of mind knowing they can fully focus on their treatment and spend more quality time with their loved ones,” said Del. Woods. “I am proud to cosponsor HB 1087, along with my colleague, Delegate Harry Bhandari, exempting metastatic cancer patients from harmful step therapy protocols and helping Marylanders, battling a terminal illness, receive the treatment they need when they need it.”
