The U.S. Senate has introduced the Safe Step Act (S. 464), a bill designed to improve step therapy policies nationwide and ensure patients are able to access their prescribed treatments.
Allergy & Asthma Network and a host of health groups support the legislation. A similar bill is expected to be introduced in the U.S. House of Representatives in the coming weeks.
Health insurance providers use step therapy, also called “fail first,” to control costs. Step therapy occurs when insurers require patients to fail the first step of treatment – typically a generic or low-cost drug – before moving on to the second step. This can happen even when the doctor and patient agree step two is the best option. Step two is often a more expensive medication for the insurer to cover.
Step therapy compromises treatment decisions. It can be dangerous to patients and lead to increased costs in the long term.
The Safe Step Act would…
- require that insurers put in place a clear and transparent process to request an exception to a step therapy policy;
- require that a group health plan grant an exemption in any of the following situations:
- Patient already tried and failed the required drug
- Delayed treatment will cause irreversible consequences
- Required drug will cause harm to the patient
- Required drug will prevent a patient from activities of daily living
- Patient is stable on a current medication;
- require a group health plan respond to an exemption request within 72 hours in all circumstances, and 24 hours if the patient’s life is at risk.
We need your help! Join us today by contacting your U.S. Senators in support of S. 464.
We appreciate your continued advocacy efforts on key issues that support optimal health outcomes for people living with allergies, asthma and related conditions!