In May 2019 CMS issued a final rule that expanded step therapy to Medicare Part B drugs but specifies that antineoplastics are to remain among the “protected classes,” and that insurers could impose prior authorization and step therapy requirements for new patients only.
As cancer treatments have become increasingly targeted and complex, the potential for increased utilization of step therapy in oncology presents unique challenges for patients and providers. This lecture series explores the implications for patient-centered care of implementation of step therapy in Medicare Advantage plans, which cover more than 20 million Medicare beneficiaries.
For more information about this project, please contact Elana Plotkin, Senior Program Manager, ACCC Provider Education.
Download a summary of what occured during the ACCC 45th Annual Meeting & Cancer Center Business Summit in March 2019, where a Deep Dive Workshop on Real-World Integration of Immuno-Oncology brought together an expert panel for a focused discussion on step therapy in the context of immunotherapeutics. Panelists explored step therapy from the perspective of different members of the care team, including a patient advocate.