Legislation Eliminates Barriers to Critical Treatments for Metastatic Cancer Patients, Would Help Patients Across Kansas Access Care They Require

Susan G. Komen^® Commends Bill Introduction; Urges Quick Passage

TOPEKA - Susan G. Komen^®, the world's leading breast cancer organization, applauds Representative Linda Featherston (D-Overland Park) for introducing legislation that would prohibit the use of step therapy protocols for metastatic cancer patients. Studies have shown that as little as a four-week delay in treatment for metastatic cancer is associated with increased mortality.

Step therapy, also referred to as "fail first," requires a patient to first try a health plan preferred drug, have that drug fail them - meaning the treatment didn't work for the patient - before they can use the treatment their provider prescribed. This health plan technique is used in an attempt to control costs; despite evidence showing step therapy requirements often adversely impact a patient's treatment and health outcomes. Although metastatic breast cancer cannot be cured, it can be treated. Treatments are highly personalized and must be based on the decisions between the patient and their health care providers in a timely manner.

"Treatment decisions, especially for diseases like metastatic breast cancer where delays or deviations could be deadly, should never be dictated by arbitrary and outdated insurance protocols." said Molly Guthrie, Vice President of Policy and Advocacy at Komen. "Cancer patients facing aggressive diseases should not be forced to have an alternative treatment fail them rather than receiving the most effective treatments from the beginning,"

HB 2526, introduced by Rep. Featherston, would prohibit the use of step therapy protocols for metastatic cancer treatments and the associated conditions caused by the patient's treatment.

"I'm pleased to partner with the Susan G Komen Foundation to introduce HB 2526. Women with metastatic breast cancer should be able to focus on maintaining their health and quality of life without having to jump through extra bureaucratic hoops," said Rep. Featherston. "Furthermore, HB 2526 frees up physicians so that they can use their time to devise the best treatment plan for their patients, instead of fighting with insurance companies"

Most step therapy protocols rely on generalized information regarding patients and their treatments and don't consider unique experiences, previous responses to treatments and any comorbidities. Additionally, step therapy policies are particularly burdensome in oncology, given the individualized nature of modern cancer treatments. Komen believes treatment decisions are most effectively made through a collaborative process involving patients and their providers, prioritizing individual needs and not based on harmful insurer policies.