July 21, 2014

Legislation curtails medication “step therapy”

A bill recently signed into law by Gov. Dannel P. Malloy will tighten rules about how insurance companies can mandate cheaper drugs before agreeing to pay for more expensive drugs, a cost-saving technique known as step therapy.

The legislation, signed by Malloy in June and at a ceremonial signing Friday, takes effect Jan. 1. It bars certain insurers from requiring patients to take cheaper medicines for more than 60 days.

At the end of that period, a patient's doctor would be able to override the step therapy regimen.

The Connecticut Association of Health Plans opposed the measure, arguing that it was unnecessary and could drive up healthcare costs.

The association also argued that sales and marketing by drug makers could have undue influence on the prescriptions doctors identify when overriding a step therapy regimen.

The Leukemia and Lymphoma Society supported the bill, arguing that step therapy can delay access to medications offering the greatest medical benefit. The Office of the Healthcare Advocate, National Multiple Sclerosis Society and Arthritis Foundation also advocated in favor of the bill.

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