Step Therapy

Mark Nuce speaks with Dr. Anita Afzali from The Ohio State University Medical Center, and Dr. Ross Maltz from Nationwide Children's Hospital about step therapy, or fail first.

This is an insurance practice that requires the least expensive drug in any class to be prescribed to a patient first, even if clinicians believe a different therapy is medically in the best interest of the patient's condition.

We talk specifically to the need for Crohn's and Colitis patients in this podcast.


· What is step therapy/fail first?

· Who decides what drugs are affected by step therapy protocols?

· How does step therapy affect patients/IBD patients?

· How often do insurance plans utilize step therapy protocols?

· How long do patients have to wait/how many ‘steps’ do they have to go through until they receive the original provider-prescribed treatment?

· Is there an appropriate use for step therapy/can it actually save costs?

· How does (OH) House Bill 72 and (OH) Senate Bill 56 address step therapy?

· Does HB 72 and SB 56 implement timeframes for responses to step therapy exception requests?

· Do these bills mandate coverage for prescription drugs?

· Have other states passed similar legislation/is Congress considering any reform?

http://www.crohnscolitisfoundation.org/chapters/centralohio

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