Murkowski amendment puts common sense parameters around insurance industry’s step therapy programs
WASHINGTON, D.C. – May 11, 2023
Patients across the United States are thanking members of the Senate Health, Education, Labor and Pensions Committee for voting to include the Safe Step Act in an amendment to the Pharmacy Benefit Manager Reform Act (S.1339) that if passed will ensure that employer health plans offer a medically reasonable and expedient step therapy exceptions process. The amendment was put forth by Senator Lisa Murkowski (R-AK) with support from Senators Maggie Hassan (D-NH) and Doc Marshall (R-KS).
Step therapy occurs when a patient’s insurer or PBM refuses to cover the cost of a medication until the patient tries and fails on treatments of their choosing. Without reform, step therapy-related delays in care can lead to severe or even irreversible health outcomes.
Step therapy reform bills have been vetted at the state level—with passage in as many as 36 states. In addition, the Safe Step Act has broad, bipartisan support in Congress.
“We are thrilled that members of the Senate HELP Committee see the importance of protecting patients and ensuring that patients can seek an exception to a step therapy protocol if its medically inappropriate,” said Leah Howard, J.D., President and CEO of the National Psoriasis Foundation. “Senator Murkowski should be applauded for offering the Safe Step Act amendment and for advancing this important policy change.”
“We applaud the Senate HELP Committee for protecting millions of people with arthritis and other chronic conditions with this vote,” says Steve Taylor, president and CEO of the Arthritis Foundation. “The ability to get a medical exception to their insurance provider’s step therapy protocol is an example of the access to quality care these patients—and every patient—deserve.”
The Safe Step Act language does not ban the use of step therapy, but instead puts common sense parameters and reasonable timelines around the practice. The legislation will give patients and their doctors a transparent and standardized process to seek an exception to a step therapy requirements that may be ineffective, cause harm, or otherwise delay needed care. Today, the Association for Clinical Oncology and the American Gastroenterological Association led over 60 medical societies in a letter endorsing the Safe Step Act.
“As oncologists, we strive to deliver the best care possible to our patients, which means providing the right treatment at the right time,” said Association for Clinical Oncology (ASCO) Chief Executive Officer Clifford A. Hudis, M.D., FASCO, FACP. “Step therapy directly impedes physicians’ ability to deliver timely and targeted care and may compromise outcomes as it delays or entirely blocks the start of provider-prescribed treatments. This brings the risk of cancer growth and inferior outcomes. While no “fail-first” policies are completely safe for individuals with cancer, the Safe Step Act puts guardrails in place to help patients access potentially lifesaving and life-extending medications in a timelier manner, and ASCO applauds the Senate HELP Committee’s efforts to advance the bill and looks forward to its future enactment.”
“People with digestive disease deserve access to recent scientific advancements that allow for precision medicine, and they’re especially vulnerable to severe or even irreversible consequences if they can’t access the right treatment at the right time. The United Ostomy Associations of America applauds the Senate HELP Committee for advancing the Safe Step Act and encourages Congress to pass the Safe Step Act in order to bring meaningful prescription drug policy reforms to the patients that need it most.” Jeanine Gleba, Advocacy Manager for the United Ostomy Associations of America, and Chairperson of the Digestive Disease National Coalition.
The “Safe Step Act” is supported by more than 200 patient and provider organizations.
The Pharmacy Benefit Manager Reform Act now goes to the full Senate for a vote.
Contact: Jen Daly
Serving the community of people impacted by psoriatic disease for more than 50 years with patient support, advocacy, research, and education, the National Psoriasis Foundation is the leading nonprofit representing individuals with psoriasis and psoriatic arthritis. The mission of NPF is to drive efforts to cure psoriatic disease and improve the lives of more than 8 million individuals in the United States affected by this chronic immune-mediated disease. As part of that effort, NPF created the Patient Navigation Center to offer personalized assistance to everyone with psoriasis or psoriatic arthritis. In recent years, NPF has funded more than $30 million in research grants and fellowships that help drive discoveries that may lead to more and better treatments and ultimately a cure. Learn more at psoriasis.org.