For the third time in the past four years, the California Legislature considered a bill that would limit and regulate a prescription drug protocol known as “step therapy.”
Also known as “step protocol,” “fail first” and “prior authorization,” step therapy is a tool used by insurers and providers to control rising costs and limit the risks of prescription drugs. The practice calls for patients to start with the most cost-effective, safest drug available and then to proceed to more costly, and sometimes more risky, drugs if the preceding step is not successful.
AB 889, by Assembly member Jim Frazier (D-Oakley), proposed a limit of two steps and would have required health plans to create a process for exceptions to the rule. The bill died in the Senate appropriations committee.
Four years ago, a similar bill died in committee. Last year, a similar bill was passed by both houses and made it to the governor’s desk where it was vetoed by Gov. Jerry Brown (D).
We asked legislators and stakeholders to share their views on the pros and cons of step therapy, as well as the pros and cons of establishing laws to regulate the practice.
We got responses from: