Video Series on Step Therapy

Healthcare experts and leaders gathered in Detroit, Michigan, to film a series of videos sharing their experiences with step therapy and advice on how to navigate it. In both a roundtable discussion and individual interviews, the group provides insight into how step therapy impacts doctors and patients and encouraging words for those struggling with it.

Step therapy is an insurance company practice that all too often results in patients being denied access to the medicines that doctors have prescribed. Many insurance companies’ step therapy requirements mandate that patients first try a series of other drugs before covering the cost of doctor-recommended medicines. This puts patient health at risk, compromises the doctor-patient relationship, and puts pressure on the time and resources of doctors and other healthcare professionals.

“It seems to be that insurance companies have made their decisions of which drugs they’re going to help cover for the patients and that doesn’t always match what’s the safest or the best for the patient’s care.” – Dr. Irene Kazmers

“Now, the hardest thing in medicine is not diagnosing or trying to determine what treatment I want to give my patients, it’s really getting them the therapy they need.” – Dr. Delfin Santos

“Patients can be their own best advocates and that’s very good for them, but they need the tools, so we put together a toolbox that they can use for going through the appeal process.” – Virginia Ladd

“I am opposed to step therapy … and I would like to put a higher priority on what is indicated for the patient based on evidence and science. I’m very happy that Let My Doctors Decide is available for patients to use as a resource.” – Dr. Irene Kazmers

“Let the doctor decide, that’s the main thing.” – Dr. Delfin Santos

"When an insurance company comes along and tells patients that they cannot have the medication that their specialist wants them to have, it breaks down the relationship between the doctor and the patient.”

“If I were advising patients struggling with step therapy, I would say you have to become your own best advocate, be persistent, and be patient. You deserve the medication and access that your physician determined you needed.”

“[Step therapy] has been a huge burden on our medical practice because in addition to all the work we have to do to care for patients, we also have to do a lot of extra paperwork.” 

“For medical professionals who are struggling with step therapy, I would say … do what you can to find efficiencies in your own office. Look at ways that you can cut down on the workload or maybe have a go-to specialist in your office who is really good at getting prior authorizations done so that way the burden of step therapy feels a little less burdensome when you’re addressing it in an efficient manner.”

“My experience with step therapy has not been positive. …. We have delayed patients their proper treatments, at times putting patients at risk with medications we feel are not appropriate.”

”My experience with step therapy has been a frustrating experience and I think that frustration is shared by the patients.”