Your Turn, NH: Patients should be able to take the drugs their doctors prescribeBY JOSHUA D. DION
April 14. 2013 3:25PM
Sadly, insurance companies are finding new ways to stall the filling of prescriptions and force people to take older, less effective, sometimes cheaper medication regardless of what their provider thinks is best. They are also forcing providers to try medications for patients that are not FDA-approved for their condition. Both of these practices are done to increase profits for the insurers. The patients are the ones losing out.
Two important patient-protection bills are progressing through the New Hampshire Legislature in an attempt to stop these insurer practices and to ensure that patients have access to the medication they have been prescribed. Senate Bill 92, which has passed the Senate and is going before the House, prohibits an insurer from requiring a patient to first fail, more than once, on medications other than what their provider has prescribed.
This tactic is called step therapy, whereby the insurer won't agree to pay for the medication prescribed until the patient first tries, and fails, several steps of other medications - regardless of the provider's judgment and expertise, and regardless of the patient, who is made to suffer longer.
Another bill, Senate Bill 91, prohibits insurers from requiring patients to take a medication that is not FDA-approved for their condition, known as "off-label prescribing." When a patient receives a drug, the label on the back has all the information on it, such as potential side effects, dosage, etc. But when a drug is taken for an off-label condition, it puts the patient at a higher risk for side effects, unwanted reactions and medication errors. That's a risk not many are willing to take without first consulting with their provider.
Stalling tactics like these insurer practices result in escalating out-of-pocket costs, debilitating conditions, additional time spent on medical visits, and fear and frustration for patients. As a nurse practitioner and prescriber in New Hampshire, I support both SB 91 and SB 92, which are designed to protect the provider-patient decision-making process - a critical component of intelligent and cost-effective healthcare.
It is time to take the prescribing power out of the hands of the insurer and place it back in the hands of those in charge of the patient's medical care.
Joshua D. Dion is owner and director of Integrated Pain Care of Bedford, LLC.