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Committee unanimously advances bill banning step therapy for metastatic cancer treatments
Summary
House Bill 11-14 would bar insurers from requiring step-therapy ("fail-first") protocols for metastatic cancer treatments and related associated conditions; the committee passed the bill 10–0 after patient advocates and oncologists urged the change.
The House Insurance Committee unanimously advanced House Bill 11-14, a bill that would prohibit step-therapy protocols for metastatic cancer treatments and for conditions associated with those treatments.
Representative Pryor, the bill sponsor, said the measure is narrowly targeted to ensure patients with metastatic disease can access prescribed treatments without being forced to try lower-tier drugs first. "House Bill 11-14 ensures Hoosiers can access the treatment their doctor prescribes without dangerous delays," Pryor said.
Patient advocates, oncologists and cancer organizations including Susan G. Komen, the Indiana Oncology Society and Hoosier Breast Cancer Advocates testified in support. Olivia (Susan G. Komen) said step therapy can be "particularly burdensome in oncology given the individualized nature of modern cancer treatments" and cited studies tying step protocols to higher utilization and delayed access. Heather Perowski, a metastatic breast cancer survivor, urged the committee to cover associated conditions that arise from cancer treatment, saying such conditions must be managed promptly so patients can remain on life-prolonging treatment.
Joey Fox of the Indiana Association of Health Plans said insurers want clearer statutory language on which "associated conditions" would be covered and requested continued negotiation; Pryor said the bill covers state employee plans, marketplace plans and HMOs, and federal law limits application to other private markets.
The committee voted 10–0 to advance the bill. Sponsors said they will continue discussions with insurers to refine definitions for associated conditions before floor consideration.
