05/04/2022

Stop Failing Patients - Step Therapy

Just released April 25, 2022 - 

“First, do no harm” is the vow all health care professionals abide by, yet the same oath is not required by other health system participants.

The most often implemented utilization management strategy by insurance companies to reduce drug spending is step therapy, colloquially known to patients as “fail first.” This practice results from negotiations between a drug manufacturer and an insurer or pharmacy benefit manager, leading to coverage of certain biopharmaceuticals. Unfortunately, the fail-first protocols mandate that a patient ought to fail on one or more drugs that their provider did not select for them, effectively de-prioritizing the disease management decisions made by providers and their patients.  READ MORE