More states move to protect patients seeking prescribed meds
The new law, which mirrors similar legislation twice vetoed by the former Republican governor, is set to be effective in mid-September.
Currently, a policy known as "step therapy" allows insurers to require patients to try the least risky or most cost-effective drugs and progress to other prescribed medications only if necessary.
Supporters, which include patient rights groups, say
Existing
But it's a cumbersome process, according to patient
"They put me through the process of: 'Have you tried this, have you tried that, let's try this,'" said Schnieders, a child psychology professor. "Because the medication that I'm on frankly is quite expensive."
Her insurer twice made her try a new medication that caused severe allergic reactions, she said. Now each January, she said, she has to justify why she wants to stay on her medication instead of switching to other drugs.
"If I'm not having severe flare-ups with my arthritis, then why not leave me on the medication that's worked for nine years?" She said. "Why keep trying to change it?"
Schnieders said she is excited that
Insurers could still require enrollees to try a generic drug before covering an equivalent brand-name prescription drug.
"It certainly doesn't ban step therapy," said
But insurers and pharmacy benefit managers argue
"Many drugs have harmful side effects or interact adversely with other medications,"
Such critics took particular issue with the part of the law providing exceptions from step therapy for patients who are "stable" on a prescription drug selected by a provider.
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