An Act Prohibiting Certain Health Carriers From Requiring The Use Of Step Therapy For Covered Prescription Drugs That Are Prescribed To Treat Cancer.
If passed, HB 05859 will directly affect insurance companies, hospital service corporations, and other entities involved in health insurance production and delivery in Connecticut. By modifying sections of the state’s general statutes, the bill will ensure that patients undergoing cancer treatment receive timely access to necessary prescription drugs without having to go through the step therapy process, thus potentially improving healthcare outcomes for this vulnerable population.
House Bill 05859 aims to prohibit health carriers from imposing step therapy protocols for prescription drugs specifically prescribed for cancer treatment. Step therapy is a cost-control strategy adopted by many health plans that requires patients to try less expensive alternatives before coverage is granted for more costly medications. The bill seeks to alleviate patient burdens by ensuring that individuals prescribed drugs for cancer can access their medications without delay or additional barriers ordinarily associated with step therapy. This restriction is to apply if the drug complies with approved FDA indications.
There may be some contention surrounding the bill, particularly with health insurance providers who argue that step therapy is a crucial method for controlling prescription costs. They may express concerns that prohibiting step therapy could lead to increased healthcare spending and affect the overall sustainability of health insurance in the state. Opponents may highlight the need for medical necessity and cost-effectiveness, fearing that the bill could encourage over-prescription or inappropriate use of expensive medications.
Notably, the bill focuses only on cancer treatment prescriptions and is crafted to assure compliance with existing FDA approvals. This specificity underscores the urgency and importance of proper treatment pathways for cancer patients and reflects a growing recognition of the need to prioritize patient health over cost-saving measures in healthcare policies.