TN: Step Therapy Introduction


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Co-Sponsor HB 1866/SB 1935

Dear [Decision Maker],

Step therapy, often called "fail first," is a process that requires patients to try and fail on one or more medications chosen by their insurer before they can access the optimal treatment recommended and prescribed by their healthcare provider. We need to reform step therapy protocols, because they can interfere with the patient-provider relationship and limit a healthcare provider's ability to tailor care to an individual patient's needs based on the provider's clinical assessment and knowledge of the patient's medical condition. Requiring a patient to follow a step therapy protocol may have adverse and even dangerous consequences for the patient who may either not realize a benefit from taking a prescription drug or may suffer harm from taking an inappropriate drug.

Patients need the ability to quickly assess their condition with their doctors and find the best course of treatment for their individual medical needs. Delays in access to the best treatment available, that could be experienced as a result of patients having to go through a step therapy protocol, can pose significant risk to the treatment of disease.

ACS CAN supports HB 1866 /SB 1935 because it protects patients by: ensuring that step therapy programs are based on clinical guidelines developed by independent experts; by ensuring that the exceptions process for step therapy is transparent and accessible to patients and health care providers; and by establishing a basic framework for when it is medically appropriate to exempt patients from step therapy.

Help ensure Tennesseans have timely access to the medications prescribed by their health care provider. Co-sponsor HB 1866 /SB 1935.

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