On September 22, 2023, the New York Step Therapy Alliance sent a letter to the New York Department of Health to raise concerns about the potential negative effects of the recently introduced step therapy protocols under the New York Medicaid Prescription Drug Program.
The letter emphasized the detrimental aspects of step therapy policies, explaining that they often force consumers to try alternative treatments, leading to adverse side effects, before their originally prescribed treatment is covered. The letter also pointed out the inconsistency of this step-therapy policy with New York’s longstanding “provider prevails” principle, which safeguards patient health and respects the expertise of healthcare providers. The letter stressed the importance of allowing healthcare providers to exercise their judgment and override step therapy requirements when a patient’s health is at risk. Finally, the letter underscored that the existing Medicaid Best Price Rule already grants the New York Medicaid program the ability to secure the lowest medication costs by requiring drug manufacturers to offer Medicaid the lowest market price. Therefore, requiring patients to try less expensive treatments before accessing more costly options is unlikely to yield substantial additional savings beyond what the Medicaid Best Price Rule already achieves.
Read the letter here.
Last Updated on September 25, 2023 by Aimed Alliance
