In Ohio alone, more than 1.3 million people are living with diabetes. Access to medications that meet their medical needs is critical as they work with their physicians to prevent costly and horrific diabetes complications, including amputation, blindness, kidney failure and heart attack. Complicating this treatment is the fact that health insurance plans sometimes make use of step-therapy protocols under which patients are required to try one or more prescription drugs before coverage is allowed for a drug selected by the patientâ€™s health-care provider. Inappropriate step therapy can delay access by making a patient try and fail on one or more medications.
During these time periods, patients may experience conditions that can be debilitating or even life-threatening. Currently there are two pieces of legislation before the General Assembly, Senate Bill 56 and House Bill 72, which would reform the practice of step therapy in Ohio. They do not prohibit step therapy. Instead, the legislation would establish a clear and independent process for requesting an exception for step-therapy protocols and put patient care back in the hands of health-care providers.
The goal of ensuring patients receive the best and most effective treatment for their condition, as recommended by their treating physician, should be the objective of our health-care system. This patient-centered approach should be used to guide medical decisions. Both bills do just that and give health-care providers the tools they need to provide appropriate patient care.
The American Diabetes Association urges lawmakers to finish step-therapy reform before the end of this legislative session. Ohio should take the opportunity to join 18 other states in reforming how step therapy can be used to better protect a patientâ€™s access to physician-prescribed medication.
Gary Dougherty, director, State Government Affairs and Advocacy, American Diabetes Association, Powell