The concept is basic, what you expect when you go to the doctor. Your doctor prescribes the medication that will help you get better, right?
Georgia law doesn’t ban step therapy, which allows insurers to make you try older, cheaper drugs before the new ones your doctor prescribes.
“What they wanted our epileptic patients to do was to fail twice on two different kinds of medication before they would give them the medication that would keep their seizures in order. If you fail, and you’re an epileptic and have seizure, you lose your drivers license for 6 months. How does a father or mother support their family or get to school? It’s so ridiculous,” says Rep. Sharon Cooper.
Lose their license or even their life. These stakes aren’t unusual, putting patients with chron’s disease in the hospital, and some of the senators in that hearing at risk of diabetic coma.
“Insurance companies are telling us what the doctors ought to prescribe rather than the doctors prescribing what we need,” says Sen. David Lucas.
The bill has four basic pillars…
“First, do no harm.”
That is, don’t make patients try something known to be harmful.
Second, don’t make them take something that could hurt them.
“The insurance tried to get the patient to take something that would have been deadly because of a cardiac problem she had,” says Rep. Cooper.
Then, if the patient has already failed a similar drug on another insurance plan, don’t make them try it again. And, if they’ve failed a drug with the same mechanism, just give them the medicine they need.
What bipartisan House Bill 63 boils down to…
“Basically this will put more control in the decision for what’s right medication for this patient between doctor and patient,” says Sen. Greg Kirk.
Where the committee indicated they thought it should be. That bill has been referred to the senate floor and should come up for a vote before the end of session.