Florida Cancer Specialists Review Highlights Risks of Insurer-Driven Step Therapy Policies in Oncology
A review by Florida Cancer Specialists & Research Institute highlights the growing risks associated with insurer-mandated step therapy policies for cancer patients. These practices, which require patients to try less-preferred treatments before accessing their physician's recommended care, can delay life-saving therapies and compromise patient outcomes. The study notes that such delays may lead to worsened health results, unnecessary side effects from inappropriate medications, and disruptions in treatment continuity. The analysis draws on peer-reviewed literature and regulatory documents between 2010 and 2025, revealing the increasing prevalence of coverage restrictions like step therapy and prior authorization. These policies are criticized for prioritizing cost management over clinical appropriateness, potentially harming vulnerable patients who lack strong support systems or resources. The authors call for reforms that include faster exceptions processes, transparency in policy standards, and reduced administrative burdens to better align with the urgent nature of cancer care.
Topics: cancer care insurance policies patient outcomes step therapy