Step therapy, also referred to as “fail first”, requires a patient to first use a health plan preferred drug and fail that therapy, prior to receiving coverage for the originally prescribed drug. Plans deploy this utilization management technique to prioritize use of low-cost drug therapies. Physicians are faced with considerable challenges in identifying drugs subject to step therapy, and sometimes are not aware if their patient has been subject to step therapy protocols at the pharmacy or treatment center.
At Komen, we believe that treatment should be determined between the provider and patient, not by insurance design. This webinar will provide an overview of step therapy, what Komen has done to advocate against these policies at the state and federal levels, and how you can advocate for yourself as a patient.
• Rebecca Birch, Manager, State Policy & Advocacy, Susan G. Komen
• Johanna Gray, Senior Vice President, CRD Associates
• Michelle Rice, Senior Vice President, External Affairs, National Hemophilia Association