Rep. Antonio Renews Call For Step Therapy Reform, Testifies On Bipartisan Bill
Lawmaker says Ohioans with chronic illnesses cannot wait for "fail first" policies

State Rep. Nickie Antonio (D-Lakewood) joined joint-sponsor Rep. Terry Johnson (R-McDermott) yesterday to present sponsor testimony for House Bill (HB) 72, legislation to reform Ohio’s step therapy practices, during the bill’s first hearing in Health Committee.

“If a patient knows that a particular medicine won’t work for her or him, they should not be forced through the practice of step therapy to try it before getting the drug that will actually work,” said Antonio. “What we’re calling for is freedom for a doctor and patient to quickly access and use the most effective medicine right from the beginning— not to prolong treatment or discomfort through several other fail-first practices.”

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 “fail first” method requires the physician to follow certain “steps” of prescribing medications, even if the final drug is proven to be the most effective.

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 previously sponsored similar legislation during the 131st General Assembly, but the bill failed to pass into law.

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