Missouri Law Protects Patients Against Ineffective Medications

Patients in Missouri will no longer have to repeat ineffective medications.

Patients in Missouri will no longer have to repeat ineffective medications.

Step therapy is a cost-savings measure used by some insurers that requires patients to take different medications from what their health care provider prescribed before agreeing to cover the cost of the original medication.

Missouri Governor Jay Nixon recently signed into law the “Step Therapy for Prescription Drugs” bill (HB 2029), which prohibits insurers from requiring patients to take medications they’ve already tried when they switch their coverage or change jobs, or if the medication is reclassified.

Step therapy doesn’t take a patient’s medical history into account, but instead draws from the insurer’s formulary or protocol, which sometimes leads to worsening of a condition.

“Only patients and their doctors know what medicines will work best for them—not insurance companies,” said bill sponsor Rep. Denny Hoskins in an interview with KMZU 100.7 FM. “When [patients] have to go try a medicine that [they’ve] already tried once and it didn’t work the first time and [they] have to go through and try it again a second time, many times, [they’re] going to miss work because [they’re] sick and don’t feel good or because [they] have to go back to the doctor or to the emergency room.”

Importantly, the law doesn’t ban the practice of step therapy altogether. It also doesn’t preclude insurers from having patients try a generic version of a medication. Rather, it prohibits insurers from going through step therapy more than once for a given medication.

The law is modeled after similar legislation recently passed in other states, including Illinois, Indiana, and West Virginia. New York, Ohio, and North Carolina have similar measures pending.

The Missouri law takes effect on August 2, 2016.