Victory in Indiana – Fighting Step Therapy
Today, Governor Pence signed into law SB41, putting limits on an insurance industry protocol, known as “step therapy” or “fail first,” which require patients to try and fail medications the insurance provider recommends before they will cover medications as prescribed by their physician. This practice has become pervasive in the insurance industry, even when the prescribed drug is deemed more medically appropriate by the patient’s physician.
Passage of this bill means that people living with arthritis, like Renda’s husband and children, won’t have to struggle to get the medication they need. Renda’s husband and two of her three children have ankylosing spondylitis.
[caption id="attachment_247" align="alignright" width="276"] Renda & Courtney Brower, after testifying in January 2016 on SB 41 in front of the Senate Health and Provider Services Committee.[/caption]
“SB41 will give my family their lives back by allowing us to more quickly receive the medication we need to be active and healthy again,” said Renda. “My husband and children won’t have to struggle through step therapy again.”
The Arthritis Foundation played a major role in passing SB41. In addition to leading the coalition, Arthritis Foundation advocates testified at both the Senate and House hearing.
Terri Miller is a Foundation Advocate and understands more than most how step therapy can negatively affect people with arthritis. A single mom with rheumatoid arthritis, Terri has struggled through step therapy to get the medication she needs.
“The whole arthritis community has to go through this and it just isn’t fair,” said Terri. “I’ve advocated for passage of this bill to do something positive related to this disease, to help the arthritis community.”
[caption id="attachment_245" align="alignleft" width="549"] Sponsors of SB41 Indiana Senator Michael Crider and Indiana Representative Martin Carbaugh.[/caption]
While SB41 gives healthcare providers a clear course by which to appeal step therapy restrictions, it does not ban step therapy, limit the number of steps an insurer can impose, or prioritize the prescribing of brand name drugs over generics.
SB41 is a victory, but we still have a long way to go. Help us create winning moments like this by becoming an Arthritis Foundation Advocate today.
Thank you to the sponsors of this bill, Indiana Senator Crider and Indiana Representative Carbaugh.