Preventing Step Therapy Protocols
Step therapy (sometimes also referred to as “fail-first”) requires patients to try and “fail” older or preferred treatment methods before accessing the most current form of treatment. This prevents patients from utilizing the most recent treatments, and it hinders patients and physicians from deciding jointly which course of treatment best benefits that patient. Often step therapy requires the most affordable therapy or drug be utilized before a newer, more expensive, and perhaps more effective treatment will be authorized by an insurance company, even when a physician believes the newer form of treatment will be the most effective.
Komen New England believes strongly that breast cancer treatment should be determined by your doctor, not insurance. We are actively advocating for legislation throughout New England that reduces insurance barriers to treatment, including preventing step therapy protocols.
If you have been affected by step therapy protocols and would like to share your story with your legislators, or for more information on this topic, please contact Ryan Tollefson, Community Health Manager, at firstname.lastname@example.org or 774-512-0408.