RALEIGH, N.C. (AP) – North Carolina lawmakers are opening hearings on an insurance practice of forcing patients to try a series of alternatives to see if they work before paying for medications recommended by their doctors.
A state House committee opens hearings Monday as it studies the prescription benefit management tool known as fail-first protocols. Pending legislation would impose limits.
Lawmakers say they’ll consider the savings insurers achieve by first requiring people to test if cheaper drugs can also work. Legislators say they’ll also consider potential abusive practices and perform a cost-benefit analysis on patient protections that could be required.
Opponents of the practice say it can be especially harmful for patients living with cancer, multiple sclerosis, diabetes and a range of other chronic and life-threatening medical conditions.
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