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Humana Jumps In: Medicare Part B Step Therapy Program Includes Cancer Drugs

 
• By Cathy Kelly

Biopharma manufacturers view implementation of management tool in Medicare Advantage plans with concern, urge US Centers for Medicare and Medicaid Services to withdraw permission for use of step therapy for Part B drugs. 

Syringes stuck in a dartboard

Humana Inc.’s Medicare Advantage plans will impose step therapy requirements on more than 40 injectable prescription drugs and viscosupplements covered by Medicare Part B in 2019, including treatments for cancer and supportive care therapy for patients undergoing chemotherapy.

With step therapy, payers require members to try and fail on preferred, often lower cost drugs before coverage is granted for a requested treatment. The tool also gives payers more...

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