WASHINGTON — One of the nation’s largest health insurers will use “step therapy” in some of its private Medicare plans next year, requiring patients to try cheaper drugs before pricey biologics and other costly medicines.

The decision by UnitedHealthcare is among the first signs that insurers plan to take advantage of a Trump administration initiative that policymakers argue will bring down drug costs for consumers.

Unlock this article by subscribing to STAT Plus and enjoy your first 30 days free!

GET STARTED

What is it?

STAT Plus is a premium subscription that delivers daily market-moving biopharma coverage and in-depth science reporting from a team with decades of industry experience.

What's included?

  • Authoritative biopharma coverage and analysis, interviews with industry pioneers, policy analysis, and first looks at cutting edge laboratories and early stage research
  • Subscriber-only networking events and panel discussions across the country
  • Monthly subscriber-only live chats with our reporters and experts in the field
  • Discounted tickets to industry events and early-bird access to industry reports

Leave a Comment

Please enter your name.
Please enter a comment.

  • Perhaps if we have to pay so much more for so little in return, we would be better off with our paying for a Consierge Physician instead?

    Then we could claim the expenses on our tax forms. I know that the family members of the current administration don’t pay their taxes; because they have an overly entitled perception of themselves, especially the one who is in our nation’s highest office of the federal government, because he was placed there for the opportunity to fill their coffers, and don’t give a nano second thought about the rest of the citizens, who are filling their coffins instead? I hope that they all are going to have to be held accountable, for a lot more than crimes and misdemeanors.

    Starting with the countless individuals who have died because of the administration’s “supreme leader,” and all the bff he has been benefitial for their increased wealth, and tax exempt from our nation’s needs just to have the neediest of our citizens live without a serious lack of a quality experience of life.

    • Publications like this are always hyping “Data.” We don’t even have standard Death Reporting requirements in this country for a reason. The collect data on everything else. Just like they underfunded and eviscerated the IRS, they did the same with medical data. One fifth of our GDP is a lot of money, yet there is no quality data on any of it. We can only estimate how many people have died, the deaths are often attributed elsewhere. We are witnessing a slow genocide, and a lot of unnecessary suffering, which has all been re-framed by our media. No other civilized country would so willingly allow their people to die for profit.

  • If Trump was serious about Healthcare costs he would allow Medicare to negotiate drug prices with the drug companies. This is just more screw the consumer to enrich insurance companies.

  • We can bet that anything that ensures profits for the Insurance Industry will be implemented here in Post Science America. Step Therapy did make some sense, but trusting the deceptive Pharma industry crooks, and liars over the ghouls in the insurance industry is sure to lead to deaths and despair. We should be already well aware, that these decisions were made by a president who is fine with causing American deaths, and despair, while furthering corporate greed and profiteering. Welcome to the Kleptocracy. we would not be Rationing healthcare like this, if we had Universal Healthcare, like the rest of the world.

    https://www.usatoday.com/story/opinion/2018/10/11/bernie-sanders-donald-trump-lies-medicare-all-health-care-column/1594863002/

  • I feel like many of the people leaving comments have an agenda.

    How many of these folks really are on Medicare Part B and have had trouble with receiving their medications?

    seriously, if a medication has an 80% success rate, 80% of the people receiving that medication will be fine. For the 20% who fail on that medication they need to move to the medication that is 92% successful. For that extra 12% the drug companies charge 500-1000 percent more.

    If you are successful on the cheaper drug, you have a drug that is waiting for when the first drug is less successful for you. If you fail off of the most expensive and sophisticated drug where do you have to go? when there’s nothing left to try you end up in Russia for phage therapy or in Peru for psychedelic treatments.

    Escalating the aggressiveness of a treatment makes sure that people receive only the drugs that they need.

  • I have to tell you, after practicing pharmacy for 33 years I think I’ve seen almost everything. Years ago
    there was a company called US Healthcare, they were big on this step therapy. What we saw most of the time was that the insurance co. wound up paying for the medication that the doctor prescribed in the first place. So it really cost the insurance co. more money by paying for a med or two or three, that the step therapy wanted and then for the proper medication. Instead of step therapy why doesn’t United Health Care ask their PBM how much they paid the pharmacy that filled the Rx , then compare it to what the pharmacy really received. We will NEVER solve the high price of drugs problem until the PBM’s are transparent !
    That is where the problem is !!!

  • Oh and while on subject of medication, since when did our President become a doctor, I am pro Trump, but this is just WRONG!!!!! DEA, CDC push our doctor’s Rx writing pen. We barely get meds to help our extreme pain!!!! You people in Washington MAKE ME SICK!!! AND I AM NOT ALONE!!!!!!!!

Sign up for our Daily Recap newsletter

A roundup of STAT’s top stories of the day in science and medicine

Privacy Policy