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Patients say getting right medications will be easier under step therapy reform proposal

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Getting access to the medications you need could soon be easier under a new proposal at the state capitol.

The plan would make reforms to "step therapy"... a practice that insurance companies use to help control costs and risks of prescription drugs.

As rose schmidt explains... patients say reforms are needed.

Members of the wisconsin step therapy coalition suffer from conditions like arthritis, psorasis or cancer.

They joined the group after they say insurance companies denied their repeated attempts to get the right medications... in favor of cheaper -- and sometimes not as experimental -- options.

But patients are hoping a new proposal could change that.

8:28:12 this is so important for those living with a costly chronic condition.... they can't express that enough.

8:17:28 my name is stephanie block..

As stephanie block recounted her medical history for a committee of lawmakers... 8:17:29 i'm here to speak in support of sb 26 32 you could not help but feel her emotion.... as she advocated for a bill she says could change many lives.

8:19:43 i want to thank you all for working hard for wisconsin patients and ensuring that we can have access to the medications that we need... thank you for your attention and i'll be happy to answer your questions 54 stephanie was diagnosed with juvenile rheumatoid arthritis when she was only eight years old.

8:31:54 so i've had this pretty much my entire life.

I don't remember not having arthritis 59 but what she can remember..

Is all the hurdles she's had to jump through in the years following 8:29:06 i actually was stepped twice -- by "stepped" she means step therapy... it's a process where a doctor prescribes a medication... and the insurance companies say instead... the patient has to try a cheaper option first.

After a year of different medications, being sick, irritable and even a hospital stay... stephanie was finally able to get the right medication.

8:30:38 i shouldn't have to suffer for an entire year just to get on the medication that the doctor said hey this is going to work 43 and it ended up working 44 the proposal she's advocating for would allow patients to ask for an exception to the step therapy protocal.... insurance companies would be forced to grant or deny the request within 3 days... or one day during emergencies.

(((8:36:30 in the cases where inidivudals face complex, chronic and progressive conditions, they need to be able to work with their doctor to expeditate that process 37))) while insurance companies have argued that step therapy keeps costs low before riskier and more expensive drugs are described... the latest version of the proposal is a compromise... with broad support from lawmakers and groups advocating for people with chronic conditions.

8:36:43 one medication could be a deal breaker for them and that doctor's going to be in the best position to know that 48 and give patients more empowerment to know what works best for them.

8:31:41 knowing that they can get the medication that they need within 24 to 72 hours -- is life changing 46 more than fifty lawmakers on both sides of the aisle have signed onto this proposal... and it's authored by the republican heads of the state's budget committee.

Similar legislation has been passed in 21




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