I recently had the opportunity to attend a panel discussion on step therapy and dermatological care on Capitol Hill on behalf of the SDPA. The SDPA is a professional member of the Derma Care Access Network (DCAN), an organization that sponsors educational initiatives and advocacy programs designed to encourage informed policymaking about the benefits of access to approved therapies and appropriate clinical care.
The panelists consisted of medical providers, a medical assistant and two patients who personally experienced the health impacts of step therapy. The discussion was regarding the appropriate and inappropriate use of step therapy. The panelists agreed that step therapy may be appropriate in the care of some disease states (i.e. Hypertension and the need to first make lifestyle changes such as decrease salt intake and increase daily physical activity before being placed on anti-hypertensive medications). The panelists expressed significant frustration in step therapy when it comes to dermatological care. Adam Friedman, MD argued that step therapy can be appropriate if it followed evidence-based medicine guidelines, but it often does not. For example, I often have patients with greater than 30% BSA involvement of plaque psoriasis that must fail several months of topical steroids and light therapies before their insurance company will even consider approving a biologic. As a provider, it is disheartening for me to know that there are more effective treatments for a particular disease state that I simply cannot get covered by insurance companies due to step therapy.
I am proud to be a part of an organization that believes in the importance of advocating for patients and the use of evidence based medicine as it relates to patient care. There are so many of you who are frustrated by step therapy but cannot attend a Capitol Hill hearing in the middle of a work week to express your frustration. You can still have your voice heard. Write to your state legislators, encourage them to place guidelines on insurance companies that will require them to follow evidence based medicine. It’s easy to get annoyed by the sea of prior authorizations that cross our desks and plague our medical assistants. Instead of continuing to complain about the problem, let’s join together and allow our voices to be heard by the policymakers in our respective states.
Respectfully,
Archana Sangha MMS, PA-C
