October 10, 2017
About seven out of 10 people oppose health insurance “step therapy,” and 95% of people agree that a physician—not an insurance company—should make the final decision on a patient’s treatment, according to a Michigan-area poll initiated by the American Autoimmune Related Diseases Association (AARDA).
“Forced step therapy delays access to necessary treatments and can cause diseases to progress. Patients need the right medication when a doctor prescribes it,” said Virginia Ladd, President and Executive Director of AARDA, headquartered in Detroit, MI.
The issue is of particular concern for patients with autoimmune diseases and their providers. Although studies have shown step therapy can provide cost savings for certain common conditions when multiple therapeutically similar treatment options are available, that’s not necessarily the case for less common conditions such as autoimmune diseases.
One study on treatment of immune disorders found no meaningful cost-saving (or other) benefit with step therapy. “Adding a forced step therapy policy in this environment may simply delay a provider’s therapy choice, supplying suboptimal care and incurring any added expense a delay in the preferred treatment might cause,” the authors wrote.
“We need to put an end to this practice now,” said Ladd. “Step therapy risks patient health, undermines the expertise of doctors and their relationships with patients, and contributes to financial waste in our health care system despite insurers touting it as a cost-saving measure. It should only be used when a doctor decides it’s best.”
According to the AARDA poll, 98% of respondents said that doctors should have the final decision on treatment for a patient with an autoimmune disease when the doctor and insurance company disagree. The poll, conducted by Lake Research Partners on behalf of AARDA, was a telephone survey of 500 healthcare consumers throughout Michigan.