Bills would limit step therapy practice

Mental-health treatment is complex, and studies show that medications in the same class for the treatment of mental illness are not interchangeable the way medications in other classes might be. This doesn’t stop health plans from imposing step therapy requirements. “Step therapy,” or “fail first,” occurs when a health plan denies a prescription medication, usually because of cost, and requires that a less expensive medication be tried first.

Step therapy policies are one-size-fits-all. They do not acknowledge that physicians and consumers should make individualized treatment decisions, recognizing the unique and noninterchangeable nature of human beings and psychotropic medications. Lack of access to the right medication has serious human as well as financial consequences.

Fail-first requirements restrict access to medically necessary medication. Failing treatment will often have serious negative consequences for mental-health consumers and their families and communities. Failed treatment often results in serious symptoms that jeopardize job performance and continued employment, housing arrangements, and family relationships, and sometimes results in hospitalization.

Ohio lawmakers are considering Senate Bill 56 and House Bill 72, which would reform step therapy practices. Eleven other states already have passed such reforms. The legislation preserves step therapy as a cost-containment measure, but provides more protections to doctors and patients to override step therapy requirements when it’s in the best interest of the patient.

I encourage Ohioans to call their state legislators to encourage their support for these bills.

Kenton Beachy Executive director Mental Health America of Franklin County Columbus