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That’s just what’s happening to patients here in Massachusetts and across the nation— before their insurance will cover the cost of the prescription their doctor prescribes – they require a patient to try and FAIL on a different medication than what their doctor ordered.
How can this be? It’s an insurance industry tactic called “step therapy” or “fail first” and it’s happening more and more to people living with all sorts of serious medical conditions.
Doctors prescribe medicine based on your individual medical history. But that specialized care can be thrown out the window when your insurer insists that you try other medicines first. This can lead to serious delays in getting the medication you need and to serious medical consequences.
Click here to read and watch stories of people who have been victims of step therapy.
Step Therapy Fast Facts:
• In 2010, nearly 60% of commercial insurers were using step therapy.
• In 2012, 54% of plans reported using for drug to treat cancer, up from 36% in the prior year.
Step therapy affects patients across a wide spectrum of disease states including: epilepsy, HIV/AIDS, Cancer, auto-immune diseases, mental health, diabetes and cardio-vascular diseases.
67% of patients who had their drugs denied because of step therapy had delays of more than 30 days before getting the medication they needed.