LETTER: Doctors, not insurers, know what’s best for their patients

To Ozaukee Press:

As a rheumatology clinic administrator, I’ve witnessed patients with chronic conditions become frustrated when physician-prescribed medications get overridden by insurance companies. The right medication is denied until patients try and fail with less effective drugs. Sen. Alberta Darling has proposed legislation that would not prohibit the step therapy process but ensure the problem is fixed. Rep. Jim Ott is also joining many legislators in offering bipartisan support for SB26 and AB24.

Step therapy creates major delays in patients getting the right medication to treat their conditions. These delays cause rheumatoid arthritis patients to experience unnecessary flare-ups that rob them of their quality of life. Uncontrolled RA increases cardiovascular disease. Patients find navigating step therapy protocols debilitating, and as physicians and administrators we are also consumed by hours of calls and paperwork in daunting appeals instead of direct patient care.

Step therapy is unfair, often forcing patients off doctor-prescribed medication onto new ones that can be ineffective. This creates painful delays for the patient. Experienced physicians know the right course of treatment, not insurers. This legislation will keep step therapy from hurting others and restore the voices of the doctor and patient voice in the prescription process.
 

Nilsa Cruz
Mequon