On May 7, 2021, Aimed Alliance sent a letter in support of New Jersey A4815, which would establish important patient protections for step therapy protocols. Some step therapy policies are inconsistent with sound scientific and clinical evidence. They can cause patients to experience harmful side effects, an interruption patient stability, and disease progression and relapse, thereby increasing health care utilization and costs.[1] A4815 would protect patients by requiring scrutiny of step therapy protocols using clinical review criteria rooted in evidence-based medicine and developed by qualified individuals. Furthermore, the bill seeks to establish clear step therapy exception processes that defer to the prescribing professional’s expertise and knowledge of the patient, ensuring each patient receives the most appropriate treatment based on his or her unique circumstances. These added protections will be crucial in ensuring the professional-patient relationship is respected and in preventing delays in individualized treatment. We are also pleased to see that the bill contains provisions requiring health plans to report certain data on their use of step therapy to the Department of Banking and Insurance, which encourages compliance with the law. Read our letter here.
[1] https://www.statnews.com/2016/08/22/step-therapy-patients-insurance-treatments/
Last Updated on May 10, 2021 by Aimed Alliance
