Challenges of Step Edits in Oncology

Panelists discuss how step edits—requirements for patients to try less costly therapies before accessing preferred treatments—create barriers in oncology. They note that these policies can undermine individualized treatment plans, forcing clinicians to prescribe suboptimal regimens despite strong clinical rationale for alternatives.

Delays from step therapy can worsen disease progression and increase patient distress. Panelists emphasize that in rapidly evolving fields like oncology, step edits often fail to keep pace with new evidence and approved therapies. They advocate for payer collaboration to integrate current data into policy design, minimizing unnecessary hurdles.

Ultimately, they stress that true value-based care should prioritize the right therapy for the right patient at the right time, not simply the lowest upfront cost.