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Coalition Asking Lawmakers to Tackle Health Insurance Practice of Step Therapy

Phenry-Wikimedia

More than two dozen organizations are asking Oklahoma lawmakers to take on a health insurance practice called step therapy.

Insurers can have patients try drugs on a preferred list other than what their doctor prescribes as a cost-control measure.

"We have to try three other medications, and you have to fail those medications before we can get to that medication that the doctor thinks is going to work best for you," said Jenniafer Walters with Oklahomans for Step Therapy Reform.

Health insurers are increasingly using step therapy. Walters, also the executive director of Epilepsy Foundation of Oklahoma, said going through a list of options before receiving a prescribed drug could subject someone suffering from epilepsy to unanticipated seizures, causing falls and other injuries.

"And then, depending how severe that seizure is, it might be a hospital stay. So, you know, the bills can add up as well," Walters said.

State legislation would require insurers to provide science-based guidelines on step therapy and tell patients how to request an exception.

"That prescription pad is not a suggestion pad. That doctor should be able to write a prescription that is going to work best for that person in any disease," Walters said.

Several states allow doctors to override the use of step therapy.

Matt Trotter joined KWGS as a reporter in 2013. Before coming to Public Radio Tulsa, he was the investigative producer at KJRH. His freelance work has appeared in the Los Angeles Times and on MSNBC and CNN.