HHS Chief Alex Azar Hears Physician Concern About Step Therapy

Doctors at an AMA conference express worry that any such move would hurt patients.

Greater competition among pharmaceutical companies is the way to bring down drug prices—something everybody these days agrees must be done, argues HHS Secretary Alex Azar. He made the point to defend the agency’s considering the idea to permit Medicare Advantage (MA) plans to use prior authorization and step therapy for drugs covered by Part B and Part D. Step therapy starts with the less costly drug, then works its way up, depending on how well therapies work (or don’t work).

In a “I want what I want when I want it” world, the proposal has garnered its share of critics. (Modern Healthcare reports on comments Azar made to an AMA conference yesterday.) And even Azar said he was “disturbed to hear” that patients who switch from one insurer to another often have to start at the bottom rung medication in step therapy even if that has been proven not to be effective.

He did not specifically say that a regulation to allow step therapy would be coming from HHS. He did defend the "agency’s move to implement step therapy and prior authorization for Medicare Part B, saying that such negotiation tools are already available in private plans,” Modern Healthcare reports.

Modern Healthcare: “‘We are ‘looking at how we can address that issue now and we would greatly appreciate you bringing to our attention other issues and things like that’, he told the room of physicians.”