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Step Therapy (sometimes also referred to as “fail-first”) requires patients to try and “fail” older or preferred treatment methods before accessing the most current form of treatment. This prevents patients from utilizing the most recent treatments, and it hinders patients and physicians from deciding jointly which course of treatment best benefits that patient. Often step therapy requires the most affordable therapy or drug be utilized before a newer, more expensive, and perhaps more effective treatment will be authorized by an insurance company, even when a physician believes the newer form of treatment will be the most effective.
In Massachusetts, legislation is being proposed to ensure Fail First protocols are based on clinical guidelines.
Join our mailing list to learn more about this important legislation and how you can advocate for this bill.