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NYSNYS NEWS: Advocates urge Cuomo to sign 'step therapy' drug bill to let doctors and patients choose medications, not health insurance companies.
NYSNYS NEWS: Advocates urge Cuomo to sign 'step therapy' drug bill to let doctors and patients choose medications, not health insurance companies.

By Kyle Hughes

ALBANY, N.Y. (August 3) -- Advocates marched outside the Capitol Wednesday to support a bill letting doctors rather than insurance companies make medical decisions about which prescription drugs are best for chronically ill people.

"We are one step away from helping New Yorkers get the medication their doctors prescribe," not what insurance companies dictate," said Kathless Arntsen, a patient and president of the Lupus and Allied Disease Association. "Gov. Cuomo please hear us -- it's time to stand with patients, advocates and providers ... we urge you to sign step therapy into law."

She said she is blind and may lose an eye because of step therapy protocols. "It's time to put prescribing back where it belongs -- in the hands of doctors who are educated and ethically bound to treat us appropriately."

The bill (S.3419) passed both the Assembly and Senate this year and not yet been sent to Gov. Andrew Cuomo. The issue has been talked about for the last six years, as Connecticut and other states have led the way in passing laws addressing patient access to medications.

Stephen Marmaras of the Global Healthy Living Foundation said step therapy "is when insurance companies require a patient to fail (to be successfully treated) first on a cheaper drug before they can get the drug their doctor originally prescribed."

The bill that has passed the Assembly and Senate "puts in place safeguards for patients so they don't have to wait too long while failing on a medication and it gives doctors a set of specific criteria for which they can appeal a step therapy procedure," he said.

The issue has united a variety of advocacy groups, including those helping patients with multiple sclerosis, cancer, blood disorders, mental illness and arthritis. Marmaras said "thousands upon thousands of patients" are affected in New York.

Advocates said that 60 percent of commercial insurers used step therapy in 2010, with more than half using the protocol to treat cancer patients in 2012.

"New York has the opportunity to be a cutting edge state by putting in place this protection for patients," Marmaras said.

The sponsor bill memo says that while step therapy can control healthcare costs for health insurers and HMOs, it must be closely regulated

"Step therapy protocols, where they are based on well-developed scientific standards and administered in a flexible manner that takes into account the individual needs of patients, can play an important role in controlling health care costs," the memo says. "In some cases, 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."