Insurance companies’ attempts to be frugal place a heavy burden on physicians’ ability to provide effective and timely treatment, according to an op-ed column in the South Florida Sun Sentinel.
Dr. Philippe Saxe, managing partner at Arthritis Associates of South Florida in Delray Beach, says insurers require physicians to get permission, called “prior authorization,” to prescribe high-cost drugs without first testing to see whether lower-cost drugs will work. The industry calls this “step therapy.” Doctors and patients often call it “fail-first.”
Saxe calls these protocols burdensome, expensive and inefficient. He praises HB 1001, which would reduce the amount of time wasted by creating a standard electronic form that can be sent directly to insurers. The bill would also empower physicians to override fail-first restrictions if they deemed it necessary.