About Rx in Reach
Rx in Reach – a project of Advocates for Responsible Care, in partnership with the Rx in Reach GA Coalition – is dedicated to helping insured Georgians access the treatments they need. We support legislation to limit step therapy, as well as policies to keep out-of-pocket costs affordable for insured families in our state.
About Advocates for Responsible Care (ARxC)
Advocates for Responsible Care is a a 501(c)3 advocacy organization that focuses on informing the public, especially the patients, about all health care advocacy issues. It advocates on behalf of ensuring full access to medical care for all Georgians.
About the Rx in Reach GA Coalition
Rx in Reach GA Coalition advocates for legislation that ends the financial and discriminatory barriers to securing vital medications. The Rx in Reach Coalition was started in September 2011 to give a voice to Georgians who struggle with affordable access to their medications and specialty drugs. We have 20 health-centered organizations as members joining efforts to advocate for legislation that ends the financial and discriminatory barriers to securing these drugs. We support legislation that provides limitations on step therapy/fail first protocols. Step therapy is a health insurance protocol that requires patients to first try a less expensive drug on a Prescription Drug list before moving up a "step" to a more expensive drug. This approach is also called "fail first” protocol.
When coverage of a prescription drug is blocked because of step therapy protocols, the patient and prescribing doctor must have access to a clear, convenient and expeditious process to a step therapy exception determination. This exception will allow the doctor to prescribe the best drug for the patient's medical needs. We are working to pass Step Therapy legislation in Georgia with the support of our bill sponsor, House Health and Human Services Chair, Rep. Sharon Cooper.
Many states have enacted, or have pending legislation designed to alleviate a controversial health insurance procedure, step therapy, which requires patients to try less expensive, often generic medications before being approved for costlier treatments. With the growing availability of generics step therapy, alongside prior authorization and benefit tiers, has emerged as a popular cost savings tool for private insurers, as well as Medicaid and Medicare programs.
A growing army of patients, healthcare providers, as well as many state lawmakers, have been pushing back and often cite cases in which patients have reported worsening conditions while being forced to ‘step through’ a series of ineffective treatments.