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Bill would bar step‑therapy rules for drugs treating conditions from advanced metastatic cancer; patient advocates and providers urge passage
Summary
House Bill 1087 would prohibit insurers from imposing step‑therapy (fail‑first) protocols for drugs prescribed to treat symptoms or side effects associated with advanced metastatic cancer. Sponsors, clinicians and cancer advocacy groups said delays can harm patients; insurers and pharmacy benefit managers were not represented at the hearing.
House Bill 1087 would prohibit health insurers from imposing step‑therapy or fail‑first protocols on prescription drugs prescribed to treat symptoms or side effects associated with advanced metastatic cancer.
Sponsor Delegate Arie Bandari told the Health and Government Operations Committee that metastatic cancer is an urgent, often terminal diagnosis and that forcing patients to try and fail on insurer‑preferred medications before accessing a physician‑prescribed therapy can cause harmful delays. “Cancer does not wait,” Bandari said. “This is not just an inconvenience. It is a potentially life‑threatening delay.”
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