Bipartisan Step Therapy Legislation To Improve Patient Access To Medicine
Rep. Antonio says Ohioans with chronic illnesses cannot wait for "fail first" policies
February 08, 2017
[ Nickie J. Antonio Home | Nickie J. Antonio Press ]

In a Statehouse press conference this morning, Rep. Nickie J. Antonio (D-Lakewood) joined the Ohio Step Therapy Coalition and Senators Charleta Tavares (D-Columbus) and Peggy Lehner (R-Kettering) to announce they will soon reintroduce legislation to improve patient access to vital prescription medicine. 

“Treatment should not be based on cost alone, but what works best for each individual patient,” said Antonio. “Ohioans battling disease and chronic illnesses cannot afford to wait. It is time to reform step therapy and remove barriers that keep patients from receiving the best treatments possible.”

Under step therapy, patients are first required to try less expensive medications before insurance companies will approve and cover the doctor-recommended medication, which is often more effective but can carry a higher cost. This method where a patient must “fail first” on the drug chosen by the insurer can leave patients with continued symptoms while a doctor follows the “steps” of medications before finally being able to prescribe the final medication.

“It is not our intention to do away with step therapy all together,” said Antonio. “Rather, we want to create more flexibility and give patients the option to get the medicine they need on the first try – not be subject to multiple steps that will inevitably fail and have to wait months or years for relief.”

The Lakewood lawmaker’s proposal would require step therapy decisions to be based on clinic guidelines and not solely the cost to health plans; provide for a transparent exceptions and appeals process for prescribing healthcare providers and patients; and establish circumstances for providers to override step therapy when medically appropriate for a patient.

Rep. Antonio will partner with Rep. Terry Johnson (R-McDermott) to introduce step therapy legislation in the House. Sens. Tavares and Lehner will introduce companion legislation in the Senate. 

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