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Committee bars step‑therapy for metastatic cancer patients, citing delays that cost lives
Summary
The Insurance Committee approved an amendment to HB 858 that prevents insurers from imposing step‑therapy (fail‑first) requirements on patients with metastatic cancer; committee members and the sponsor said delays of days or weeks can be devastating.
The House Insurance Committee unanimously approved an amendment to House Bill 858 that would prohibit step‑therapy (commonly called “fail‑first”) requirements for patients with metastatic cancer.
Representative Alexander, who sponsored the amendment, framed step therapy as an insurer policy that forces patients to try alternative, insurer‑preferred drugs before covering the medication their prescriber determined was appropriate. “This process forces cancer patients to take medications that may be less effective or even harmful before they can access the treatment their provider has determined is best,” Alexander said. He said delays of days or weeks can be fatal for patients with metastatic disease and urged members to eliminate the requirement for that population.
Alexander and other members recounted cases in which patients waited up to 10 days for insurer approval; the sponsor said those delays can have “devastating consequences.” Committee members emphasized that TennCare and Medicare do not impose the same step‑therapy requirements in the sponsor’s account, and the amendment is targeted at commercial insurers.
The committee voted to advance HB 858; the clerk recorded 18 ayes and 0 nays. The bill now moves to calendar and rules for further consideration.
