Susan G. Komen® Commends Bill Introductions; Urges Quick Passage
NASHVILLE – Susan G. Komen®, the world’s leading breast cancer organization, applauds Representative Rebecca Alexander (R-Jonesborough) and Senator Bo Watson (R-Hixson) for introducing legislation that would prohibit the use of step therapy protocols for cancer patients. Studies have shown that delays of over 12 weeks for the treatment for metastatic breast cancer are related to adverse survival outcomes measured from initiation of first treatment.
Step therapy, also referred to as “fail first,” requires a patient to first try a health plan preferred drug, have that drug fail them – meaning the treatment didn’t work for the patient – before they can use the treatment their provider prescribed. This health plan tool is used in an attempt to control costs; despite evidence showing step therapy requirements often adversely impact a patient’s treatment and health outcomes. Komen believes treatment decisions are most effectively made through a collaborative process involving patients and their providers, prioritizing individual needs and not based on harmful insurer policies.
“Cancer patients facing aggressive diseases deserve immediate access to the most effective treatments from the start, and not to be forced to fail on an alternative treatment first,” said Molly Guthrie, Vice President of Policy and Advocacy at Komen. “Treatment decisions, especially diseases like metastatic breast cancer where delays or deviations could be deadly, should never be dictated by insurance protocols.”
HB 2213/SB 2361, introduced by Representative Alexander and Senator Watson, would eliminate the use of step therapy protocols for cancer treatments and associated conditions caused by the patient’s treatment. Breast cancer treatments can be highly personalized and should be based on the decisions between the patient and their health care providers in a timely manner.
“It is essential that cancer patients have access to the most efficient and effective treatment as soon as possible. By eliminating step therapy protocols, this important legislation will help ensure that occurs in Tennessee,” said Rep. Alexander. “It is an honor to be the sponsor of House Bill 2213, and I commend Susan G. Komen for all of the support it provides to cancer patients across our state.”
Most step therapy protocols rely on generalized information regarding patients and their treatments and don’t consider unique experiences, previous responses to treatments and any comorbidities. Additionally, step therapy policies are particularly burdensome in oncology, given the individualized nature of modern cancer treatments.
