Susan G. Komen® Commends Bill Introduction; Urges Quick Passage
OKLAHOMA CITY –Susan G. Komen®, the world’s leading breast cancer organization, applauds Representative Nicole Miller (R-Edmond) for working with Komen to introduce legislation that would prohibit step therapy requirements for metastatic cancer patients. Komen believes patients and their physicians should be able to make treatment decisions based on the particular needs of each patient without the burden of harmful insurer policies.
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. Step therapy is a tool health plans use in an attempt to control costs; despite the potential impact it might have on a patient’s treatment and health outcomes.
“Every patient should be able to use the treatment option that works best for them and is recommended by their provider, and this is especially important for metastatic cancer patients who have aggressive cancers and can’t wait for a treatment to fail just to get the originally prescribed treatment,” said Molly Guthrie, Vice President of Public Policy and Advocacy at Komen. “Insurance design should not dictate treatment protocols, especially when recent data show these protocols result in increased costs for insurers.”
HB 2748, introduced by Rep. Miller, would eliminate step therapy protocols for metastatic cancer treatments and associated conditions. Although metastatic breast cancer cannot be cured, it can be treated. Treatment is highly personalized and must be based on decisions made by the patient and their health care providers, as they are most capable in determining the appropriate treatment for patients.
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.
“As a breast cancer survivor, myself, I know how vital timely, effective treatment is. Rather than immediately beginning the drug therapy prescribed by the physician with firsthand knowledge of their case, ‘fail first’ policies waste precious time exploring alternatives and needlessly put the lives and health of patients at risk,” said Rep. Miller. “It is my sincere hope that this bill helps save the lives of patients with advanced, metastatic cancer.”
Ensuring patients are receiving consistent and effective treatments is even greater in situations when treating patients with potentially life ending diseases such as metastatic breast cancer, where any delays or deviations could be deadly.