Connecticut House Bill HB05631

Connecticut 2019 Regular Session

• Introduced: 1/18/19
• Refer: 1/18/19

Caption

An Act Prohibiting The Use Of Step Therapy For Certain Prescription Drugs Prescribed To Treat Cancer.

Impact

If enacted, HB05631 would significantly affect how insurance companies and healthcare providers approach the treatment of cancer. By prohibiting step therapy for cancer medications, the bill aims to enhance patient autonomy and streamline the process of receiving the most effective treatment without unnecessary delays. This change would potentially lead to improved health outcomes for cancer patients, as it allows for the use of targeted therapies without imposing prior authorization hurdles based on insurance protocols.

Summary

House Bill 05631 seeks to amend Title 38a of the general statutes to prohibit the practice of step therapy for certain prescription drugs prescribed specifically for cancer treatment. Step therapy, often referred to as 'fail-first' therapy, requires patients to try one or more medications before insurance will cover the prescribed medication. The bill aims to ensure that patients diagnosed with cancer have immediate access to the medications their healthcare providers believe are most suitable for their treatment, without the barrier of requiring a trial of alternative medications that may not be appropriate for their specific condition.

Contention

The bill may face opposition from insurance providers who argue that step therapy is an important cost-control measure that encourages the use of more cost-effective treatments before moving to more expensive options. Opponents to the bill may contend that such a prohibition could lead to increased healthcare costs. However, supporters argue that the benefits of timely and effective treatment for cancer patients far outweigh the potential financial implications for insurance firms. This debate reflects broader discussions about the balance between cost management in healthcare and providing patients with immediate access to necessary treatments.