HARTFORD, Conn. (WNTH) — Dr. Howard Rogers is a Norwich dermatologist who remembers how writing a patient’s prescription used to be a thrill, knowing they would get better.
“The patient would fill their prescription and his or her disease or quality of life would start to improve as quickly as possible,” said Dr. Rogers.
Now, he said due to something called “step therapy” that thrill is gone.
“The excitement that my patient is going to get the right medication right away has been replaced with trepidation. How many hoops will I, my staff and the patient have to jump through with the insurer to get the treatment that I’ve prescribed?”
Step therapy happens when a patient’s insurer refuses to cover the cost of a covered and prescribed medication until a patient tries and fails on several different medications. Patients and physicians said that can cause serious medical consequences
“Step therapy does not take into account a patient’s medical history,” said Patrick Stone of the National Psoriasis Foundation. “It is medical bureaucracy at its worst.”
Advocates to end the Safe Step Act spoke with some Connecticut lawmakers virtually.
Currently, the bill has 150 bi-partisan co-sponsors in the U.S. House of Representatives. In addition to Representatives Courtney and Larson, Representative Jim Himes has made a commitment to co-sponsor. The bill also has commitments to co-sponsor from Senator Richard Blumenthal and Senator Chris Murphy.
More than two dozen states, including Connecticut, have passed step therapy reform on the state level, but federal action is needed to ensure the same protections are in place for insurance plans that are regulated on the federal level.
Windham resident Paula Haney’s son was diagnosed with psoriatic arthritis.
“Before the insurance company would pay for this medication, he was forced to try and fail at a less effective medication for 90 days.”
During that time, he suffered irreversible damage, she said.
Ben Rader, of West Hartford, has aggressive Crohn’s disease. His insurance company denied his doctor’s prescription, instead approving months of steroids.
“I’ll never know how much better my situation could have been had we just been able to get the right medication at the right time,” said Rader.