From Health Affairs Today <[email protected]>
Subject Prescription Drug Step Therapy Protocols Vary Widely Across Health Plans
Date November 15, 2021 9:00 PM
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On the Blog: How China has patiently developed pharmaceutical innovation
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The Latest Research, Commentary, And News From Health Affairs

Monday, November 15, 2021

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Prescription Drug Step Therapy Protocols

A new paper on pharmaceuticals focuses on prescription drug step therapy
protocols.

In the November issue of Health Affairs, Kelly Lenahan and coauthors
examined commercial health plans' prescription drug step therapy
protocols

that determine patients' eligibility for specialty drugs.

Across the ten diseases they studied, most of the commercial plans'
step therapy protocols were more stringent than the treatment guidelines
adopted by national clinical organizations. Further, "different plans
applied step therapy protocols with markedly different frequencies and
required patients to step through different numbers of prior
therapies."

Many step therapy protocols are inconsistent with leading clinical
organizations' recommended treatment pathways. "There is a risk that
if plans use these protocols primarily to reduce costs, they may
compromise sound clinical decision making," the authors caution.

Today on Health Affairs Blog, James Robinson discusses how China has
patiently developed drivers of innovation

in its domestic pharmaceutical sector and now is poised to expand into
global markets.

Elevating Voices: Native American Heritage Month: In a Narrative Matters
essay, Terry Cross and Daryle Conquering Bear Crow called for equitable
child welfare

for American Indians and Alaska Natives. State and county managers
"too often fail to realize that child safety can best be realized when
states and tribes work together, empowering each other to fulfill their
roles," they wrote.

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Variation In Use And Content Of Prescription Drug Step Therapy
Protocols, Within And Across Health Plans

Kelly L. Lenahan et al.

Competing With, And Learning From, China In The Global Pharmaceutical
Innovation Race

James C. Robinson

Child Welfare In Indian Country: A Story Of Painful Removals

Terry L. Cross

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Ensuring Success: Best Practices For A Smooth Electronic Visit
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