Michael Reff

The Perils and Consequences of Payer Step Editing (“Step Therapy”) in U.S. Medical Oncology: Evidence, Case Examples, and Policy Remedies

Step therapy ("fail-first") policies require patients to initiate treatment with a payer-preferred regimen, often selected for cost, before coverage is granted for the oncologist-recommended therapy. In medical oncology, where biologic heterogeneity, biomarker-directed therapy, a...