On Wednesday, patients from all over the state packed a hearing room to tell their stories about how step therapy delayed or prevented them from getting the treatment they needed. The Senate Committee on Health and Human Services and the Assembly Committee on Health held a joint public hearing on legislation I authored with State Representative John Nygren of Marinette that will reform step therapy.
Many patients shared their stories of how they were forced to "fail" a drug or treatment plan before they can access the medicine their doctor prescribed. This is known as step therapy. Insurance companies use it to reduce costs by requiring patients to try cheaper alternatives first. Unfortunately, step therapy often ignores a patient's medical history and creates red tape that blocks patients from the best healthcare for them.
Patients are often required to go through step therapy even if they already tried the cheaper drug under a different health plan or when the cheaper alternative interferes with other medications they are currently using. While insurers often have an exemption process from step therapy protocols, it can be unclear and results in an unnecessary back and forth between the patient, doctor, and insurance company; all of which delays care.
Since both committees held a public hearing on our step therapy bill, it's my hope they will quickly vote to recommend it for passage in both houses.
