Bill would bar step‑therapy rules for drugs treating conditions from advanced metastatic cancer; patient advocates and providers urge passage

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.”

Co‑sponsor Delegate Dereck E. Woods (appearing with Bandari) emphasized that step‑therapy protocols can require weeks or months of trial and error and that patients with stage‑4 disease often lack the time to undergo such delays. “Patients who are already navigating the urgency of now due to their prognosis are made to suffer from ineffective substitute generic medications prior to receiving medication initially prescribed by their physician,” Woods said.

Patient advocates and clinicians supported the bill. Angelica Katz of Susan G. Komen said step therapy can prevent metastatic patients from receiving immediate treatment for associated conditions such as severe pain, nausea, lymphedema and neuropathy. “The delay can have potentially deadly consequences for a metastatic cancer patient,” Katz said. Survivor witnesses described life‑altering delays and quality‑of‑life impacts when insurers required step‑therapy trials before approving treatments to relieve symptoms.

Sponsors said the bill aligns with guidance from oncology practice and with policies passed in multiple other states; they described the proposal as narrow in scope, applying only to drugs used to treat symptoms or side effects of advanced metastatic cancer.

No vote was taken at the hearing. Committee members thanked witnesses and said they would consider the bill in subcommittee; several testifiers said they expected to work with insurers and regulators on implementation details.

Why it matters: Advocates and clinicians said that for people with advanced metastatic cancer, delays caused by step‑therapy rules can worsen symptoms, reduce quality of life and in some cases affect survival. The bill seeks to ensure physician judgment and timely access for palliative and symptom‑management treatments.

What comes next: The committee will consider stakeholder input and possible technical edits in follow‑up proceedings.