Step therapy isn't a therapy at all. It is an insurance company tactic that often requires you to try one or more drugs before getting the medicine that your doctor prescribed.
Insurance companies use this with patients to maximize their profits. Here are few reasons why step therapy is harmful:
It prevents the right medicine from getting to you at the right time.
It limits the doctor’s decision-making ability.
It opens the possibility of otherwise preventable health complications.
It is highly inefficient and wastes money.
What can be done?
Health care decisions and insurance coverage policies should begin with a focus on improved patient health.
Step therapy should only be used if your doctor thinks it’s best. And when you encounter step therapy, it should be easy to work with an insurer to get the medicine you need.
If you have encountered step therapy, our patient guide can help answer questions about how to appeal decisions, work with doctors and insurance companies, and get the medication that was initially prescribed.