Columbus – Senators Charleta B. Tavares (D-Columbus) and Peggy Lehner (R-Montgomery) will soon introduce legislation to make Ohio’s step therapy process more transparent. Step therapy, or “fail first,” is a cost-cutting process in which a patient is not permitted to immediately take the medicine prescribed by their doctor. Instead, they are forced to take a series of steps to try other, cheaper medications first. When patients are forced to take several drugs before they can take the doctor’s prescribed medication, illnesses can sometimes progress unnecessarily if the medication taken during the step therapy protocol is ineffective.

“Senator Lehner and I want to make sure we are putting the health outcomes of patients first,” said Senator Tavares. “We understand the need to cut costs, but it cannot come at the expense of a person’s health and wellbeing. Our legislation will implement a series of reforms that will make the process easier to understand while also offering safeguards so step therapy works in everyone’s best interests.”

The legislation will be a re-introduction of Senate bill 243 from the 131st General Assembly with some minor changes. Some of the most important features of the bill include:

  • Requires insurers to lay out the specific order in which medication should be taken under step therapy
  • Grants an exemption if the medication will likely cause an adverse reaction or physical or mental harm to the patient
  • Allows exemptions for instances when a patient has already tried a medication under a previous health insurance provider.

“We are not trying to end the practice of step therapy in Ohio; rather we are trying to join the 11 other states that have introduced similar legislation by protecting patients from the unnecessary burden of pain and suffering. Step therapy should be an open and transparent process with uniform standards for all insurance companies. The legislation sponsored by Senator Lehner and I will make sure that a patient’s health is the first priority,” stated Senator Tavares.

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