Insurance needs to put patients first

As a rheumatologist, I’ve seen firsthand how rheumatic diseases can make even the simplest tasks painfully difficult. My patients trust me to help them lead healthier, more comfortable lives. Because there is no one-size-fits-all approach to care for rheumatic disease, I tailor each patient’s treatment regimen to their unique needs.

Unfortunately, when I prescribe a medication that I believe will work, insurers often force my patients first to try a drug that I know won’t work

— prolonging my patients’ pain and increasing their risk of disability and joint damage (in the case of inflammatory forms of arthritis). This absurd practice, called “fail first” or step therapy, undermines the clinical judgment of physicians, leads to delays in effective therapy, and puts patients’ health at unnecessary risk. By interfering in my patients’ care, insurers are essentially practicing medicine without a license, and it’s my patients who suffer.

Congress can remedy this problem by supporting the Restoring Patient’s Voice Act (H.R. 2077). This bill would empower patients to seek exceptions to step therapy and restore the role of physicians in treating patients. It would also require insurers to consider the patient’s medical history and the provider’s expertise in partnership with their own before denying a treatment.

It’s time to stop wasting time and money on ineffective treatments just for the sake of insurance company policy. Elected officials should put patients first by supporting this common-sense legislation.

— Mohit Shukla, Trenton