Step Therapy

Physicians and patient advocacy groups are rallying behind a renewed legislative effort in Congress to amend what they claim are harmful step therapy practices that often delay or deny effective treatments to people with chronic conditions.

A significant number of children with juvenile idiopathic arthritis treated prior to the treat-to-target era demonstrated persistently active disease up to 5 years later, according to data from an Italian pediatric hospital.

The ACP held its annual leadership event May 14 and 15 in Washington, D.C., where members of the organization met with U.S. lawmakers to discuss their health policy priorities.

Consumers should be aware of Medicare Advantage plans limiting therapy through prior authorization and step therapy requirements during open enrollment, according to a press release from AAO and ASCRS.

Despite a mounting number of state-level laws enacted to protect vulnerable patients against step therapy protocols, without official enforcement, these laws safeguard less than 10% of patients, according to data published in Health Economics Policy and Law.

Step therapy protocols and prior authorization regulations in Medicare Advantage and Part D plans are limiting access to needed medications and should be suspended by CMS for the duration of the COVID-19 pandemic, according to the clinical spokesperson for the American Academy of Ophthalmology

A bipartisan bill introduced in the U.S. Senate this week would establish guidelines to prevent the inappropriate use of step therapy in employer-sponsored health plans, and create a process for patients and their physicians to seek exceptions, according to a statement from the American College of Rheumatology.

Although 90% of patients with rheumatic diseases have health insurance, 57.13% report struggling to afford their medication, with one-quarter paying more than $1,000 out of pocket each year for treatment, according to a survey from the American College of Rheumatology.

High-intensity step training resulted in better improvements in walking, gait and balance confidence compared with low-intensity training, in patients with chronic stroke.

More than 100 patient advocates, including physicians and health professionals from the American College of Rheumatology, took to Capitol Hill this week for the organization’s annual Advocates for Arthritis event, to call on legislators to support a trio of bills that would reform step therapy and increase the number of pediatric rheumatologists in underserved areas.