AR SB 446 – Step Therapy for Stage 4 cancer

Komen Ozark is pleased to announce that SB 446 has been sponsored and filed by Senator Greg Leding. Komen Ozark has been working with Senator Leding on this very important piece of legislation that will not only benefit stage 4 breast cancer patients, but all metastatic cancer patients. Lauren Marquette, Executive Director, Vicki Cowling, Director of Mission Services and advocate, Torie Smith, will be traveling to Little Rock today to support and testify on this needed legislation.

We know that stage 4 cancer patients do not have the time to fail first on other cancer therapy drugs. Physicians, working with their patients, must be able to initiate the best therapy for treating advanced cancers. This also must be done without the burden of overly restrictive cost containment policies.

This legislation prohibits a health plan from requiring a patient with stage four advanced metastatic cancer to undergo step therapy if the use of the approved drug is consistent with best practices for the treatment of stage four advanced metastatic cancer.

More about Step Therapy:

Step therapy, also referred to as “fail first”, requires a patient to first try a preferred (often generic alternative) drug prior to receiving coverage for the originally prescribed drug.

Step therapy is a method of utilization management that health plans employ to control costs by beginning treatment with a more cost-effective drug therapy and then progressing to the newer, more costly treatments only if necessary.

According to a study published in the American Journal of Managed Care, step therapy may create barriers for members to receive medication, and ultimately result in higher medical utilization costs.  These protocols should optimize affordable, effective and appropriate access to care, not lead to delayed treatments, poor patient outcomes and increased medical costs.

Unfortunately, most step therapy protocols rely on generalized information regarding patients and their treatments as opposed to considering unique patient experiences and responses to different treatments.

“Because stage 4 breast cancer patients, like me, don’t have time to fail first on other drugs.” Torie Smith

About Metastatic Breast Cancer:
Currently, in the U.S. more than 154,000 people are living with metastatic breast cancer.

Metastatic breast cancer is an advanced stage of breast cancer where tumor cells have spread to other parts of the body.  Most breast cancer deaths are a result of metastasis.

Although metastatic breast cancer cannot be cured, it can be treated.  Treatment is highly personalized and must be based on decisions made by the patient and their healthcare providers, as they are most capable in determining the appropriate treatment for patients.

Ensuring patients are receiving consistent and effective treatments is even greater in situations when treating patients with potentially life ending diseases such as metastatic breast cancer, any delays or deviations could be deadly.