Prohibiting step therapy protocols for certain cancer drugs.
If enacted, AB836 would significantly impact state laws that currently allow insurers and other parties to require step therapy protocols. Such requirements often delay access to the most effective treatments for patients battling metastatic cancer, as they compel patients to first attempt less effective treatments. By overriding these protocols, the bill promotes timely access to necessary medications and supports better health outcomes for patients with serious conditions.
Assembly Bill 836 aims to amend existing statutes by prohibiting insurance companies, pharmacy benefit managers, and utilization review organizations from imposing step therapy protocols for drugs prescribed for metastatic cancer or associated conditions. The bill specifies that these drugs must be FDA-approved, adhere to best practice standards in treating metastatic cancer, and be supported by peer-reviewed, evidence-based research. This legislative move seeks to eliminate barriers for patients in accessing essential medications necessary for their treatment.
The bill has generated notable points of contention among healthcare stakeholders. Supporters advocate for the patient's right to receive the most appropriate care without unnecessary delays, emphasizing the importance of patient-centric treatment options. Conversely, opponents argue that removing step therapy requirements may increase costs for insurers and potentially lead to prescription drugs being overprescribed without proper clinical oversight. The debate continues over balancing patient needs, insurance practices, and overall healthcare costs.