Last Thursday's letter "Step therapy saves money for patients" from Scott Solsman gave a misleading impression that Ohio Senate Bill 56 and Ohio House Bill 72 would stop step-therapy requirements. Actually, the legislation seeks to reform step therapy and provide a framework for reasonable controls.
In my practice as a rheumatologist, I already follow step-therapy requirements. My goal is not to prescribe the most expensive medicine I can; far from it. But there are cases in which a patient’s individual circumstances require a certain prescription. The treatment for each patient needs to be tailored to the underlying disease and around the risks of other medications or diagnoses such as kidney disease, cancer or heart disease.
Some medications required with step therapy are more dangerous for patients to take and would increase their risk for a bad side effect or outcome. Not only is step therapy not in the patient’s best interest, but any projected savings will quickly evaporate with the cost of treating the outcomes of either the underlying disease, such as rheumatoid arthritis or lupus, which is not being treated adequately with the recommended step therapy medication, or the complications of the wrong medication for that patient causing another disease or problem.
Doctors also care about saving money in the health-care system. SB 56 and HB 72 set forth specific situations in which step therapy cannot be imposed, such as when the doctor is simply renewing a prescription for a medication on which the patient is doing well. It also simplifies the appeals process that currently bedevils medical office staff and delays access to life-saving medications for patients.
These bills will not eliminate step therapy but rather put safeguards and guidelines in place that are patient care and outcome centered.
Dr. Stephanie Ott
Ohio Association of Rheumatology