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2017-02-13 Oregon Step Therapy

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State Advocacy Spotlight: Step Therapy in Oregon

Posted: February 13, 2017


Like multiple other states across the country, Oregon is tackling step therapy reform this year and has made great progress so far. On January 9, step therapy legislation (SB 526) was introduced in the State Senate by Senator Jeff Kruse and will be heard by the Committee on Health Care on February 21. This important legislation seeks to place limits on step therapy in three key ways: one, it would require insurers to develop their step therapy protocol using recognized established clinical guidelines that take into account the needs of atypical patients and diagnoses; two, it would establish a clear and transparent process under which physicians can override protocols based on medical evidence and necessity; and three, it establishes a mandatory timeline for insurers to respond to requests for overrides.

If their duration and effectiveness are not carefully monitored, step therapy protocols can lead serious negative patient outcomes. Because insurers usually decide what step therapy drugs to require based on financial—and not medical—reasons, requiring patients to try medications not prescribed by their physicians puts them at a much higher risk of adverse reactions and complications. SB 526 is yet another critical step towards ensuring that patients across the country have timely access to effective and safe treatments without the unnecessary delays and the increased risks.

CSRO applauds the efforts of Senator Kruse and cosponsor Senator Lew Frederick who both recognized the need for step therapy reform in Oregon. We will continue to support SB 526 throughout the legislative process. Please continue to check the CSRO websites for updates on the status of this bill and other step therapy reform throughout the country.

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