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10-year-old Tucson advocate testifies for bill to improve 'step therapy' process in Arizona

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Posted at 2:25 PM, Mar 26, 2021
and last updated 2021-03-27 18:16:40-04

TUCSON, AZ — A 10-year-old from Tucson is receiving a hands-on learning experience after testifying in front of Arizona Congress, hoping for a win against insurance companies.

Like many kids, Cassidy Middleton spent most of the last year learning from home. But when the classroom logged off, she kept working to help push legislation through Congress.

Cassidy Middleton was diagnosed with juvenile arthritis, or JA, a disease that affects her joints.

"Sometimes it feels like somebody is hitting me or punching me, or something like that," said Cassidy. At times, her arthritis is so bad that she is forced to use a wheelchair.

"A lot of people don’t know that JA, juvenile arthritis, is actually an autoimmune disease," said Kari Middleton, Cassidy's mom. "So it’s her body attacking joints thinking that it’s [a] disease."

For years, Cassidy has been subjected to "step therapy," a process by insurance companies that forces patients to try less expensive medications first, before moving up to more expensive medications prescribed by doctors.

"We were supposed to start with Humira, but the insurance company moved us to a drug called 'Enbrel' because it was less expensive," said Middleton.

In some cases, step therapy is meant to be a less expensive option for patients, but Cassidy said her condition has only gotten worse as insurance companies stonewall her doctor's prescribed medication.

On February 3, Cassidy testified to the Arizona Senate Health and Human Services Committee in favor of bill SB1270, which would "require insurers to create a process that allows individuals to request an exception to the step therapy protocol."

"The difference in cost between medications is not enough to justify my insurance making a medical decision that goes against what my doctor thinks is best," she said to the committee.

"Having to fail first when they’ve already tried a similar drug can be really detrimental to their health," said Arizona State Senator Nancy Barto, the primary sponsor for SB1270. "She’s just been a trooper. She really has. It’s hard to say no to a child who is so well-spoken and shares a personal story that is the story."

On March 3, SB1270 was passed unanimously by the Senate and is currently awaiting a vote in the House of Representatives.

“Never ever give up," said Cassidy.