Should Health Insurance Companies Be Able to Prioritize Cheaper Drugs?

Feb 19, 2019

Credit Brandon Giesbrecht / Flickr

How much influence should health insurance providers have over which drugs you take? That’s an issue lawmakers are debating in Richmond.

Republican Delegate Glenn Davis of Virginia Beach isn’t just a lawmaker trying to work on a health-care issue. He’s also a husband whose wife got caught up in a disagreement over the drugs her doctor wanted versus the drugs her health insurance provider would pay for. Then he realized many of his constituents face similar situations with all kinds of medical conditions. So he introduced a bill.

“If you go through a step therapy process and you are on a good drug that you are stable on and getting a positive outcome and you change insurance carriers, you can’t be forced to go through a step therapy process all over again.”

Becky Bowers Lanier represents the Hemophilia Foundation and the Breast Cancer Foundation. She says patients should not be forced to take cheaper drugs when the more expensive ones are already working.

“A person with breast cancer may not have the luxury of waiting to see if you’re going to fail. How do you define failing to a person with cancer?”

The bill also eliminates potential conflicts of interest on formulary committees, making sure people representing pharmaceutical companies aren’t also sitting on panels that decide which drugs are taken first.

This report, provided by Virginia Public Radio, was made possible with support from the Virginia Education Association.