Statement by Paul Macielak, president and CEO
“It’s unfortunate that some doctors and advocacy groups are not giving New Yorkers all the facts about ‘step therapy,’ or therapeutic substitution, and trying to sell legislative proposals as ‘consumer protection.’
“The facts are, as outlined on the attached ‘Reality Check’ from the New York Health Plan Association, plans use step therapy to promote quality and efficacy to help ensure patients get the right drug not just the newest and often most expensive one, and also to help protect patients from being saddled with higher copayments and out-of-pocket costs for their prescriptions.
“A recent investigation by doctors at the University of Michigan and Ohio State University and reported in the Journal of the American Medical Association (JAMA)1 found Americans spent an extra $73 billion between 2010 and 2012 on pricier brand-name drugs because physicians don’t recommend equally effective generics. And consumers paid nearly one-third of those additional costs through out-of-pocket payments. Moreover, the report found that therapeutic substitution ‘offers the potential to decrease expenditure and potentially improve the efficiency of the health care system.’
“We have a responsibility to ensure New Yorkers have access to high quality and cost effective health care. Efforts to eliminate or ‘curb’ therapeutic substitution run counter to both those objectives.”