New proposal looks at reforming step therapy in Wisconsin
It may soon be easier to get the prescriptions you need.
A proposal that is making its way through the Wisconsin senate would allow patients to get the correct medications to treat their condition regardless of price.
Currently, insurance companies can force a patient to try less-expensive alternatives first, also known as step therapy.
Divisional Director of Pharmacy at HSHS Sacred Heart and St Joseph's Hospitals, John VanDeVoort, described the problem with the current regulations.
“A doctor may feel that a drug treats a condition perfectly based on evidence, but a patient may be forced to try an older drug just because it is less expensive”, VanDeVoort said. “If a patient is moving from one insurance company to another, say with a change of jobs, they may have already failed that first drug and have been stable on a more expensive drug. When they move to another insurance company, they're forced to try that first drug again"
VanDeVoort then commented on the benefits of the new proposal.
"I definitely think it is a good thing, over half the states have passed a similar bill like this addressing step therapy", he said. "Really, the goal is to set up a standardized process that helps the patient. I think the process will be more transparent so patients will not wait as long to hear approvals and be able to know where their approval process is at."
The new proposal still needs to be passed by the state assembly before it makes its way to Governor Tony Evers for final approval.