Step therapy use is increasing steadily
Step therapy is the practice used by health insurance companies to control cost in health care system. Recent studies have shown that, nearly 67% of insurers were using step therapy. If this practice continues, patients will not be able to get an effective treatments originally prescribed by doctors.
- Commercial insurers are using step therapy
Recent studies have shown that, the US has spend $3 trillion annually on health care process. As a result, commercial insurers are using step therapy to force people into taking older, less expensive drugs that are often associated with more side effects or lower safety profiles in order to save money.
This approach used by health insurance companies, can delay access to appropriate treatments which are originally prescribed by doctors. It can also cause side-effects and life-threatening risks from inappropriate medicine.
Contrary to belief, Step therapy does not save money
Contrary to belief, Step therapy does not save money though. This kind of treatment approach may in fact be cheaper on the short term, but it is much more expensive on the long run.
- Insurers assume step therapy controls cost
Insurers assume step therapy controls cost by cutting on immediate expenses, but several studies demonstrated that the use of older, less safe medication often ends in an increase in hospital admissions and emergency room visits.
- Will incur higher health costs in later stages of your treatment
Also you will incur higher health costs in later stages of your treatment, as a condition that is not properly treated in its initial stages,is doomed to worsen itself incurring into higher costs later.
Step therapy poses a serious risk to your health:
Step therapy poses a serious risk to your health, as older drugs are many times associated with serious or life-threatening risks that were eliminated by novel, more technologically advanced drugs. This is particularly true for cancer chemotherapy, as cheaper drugs cause side effects that are often much more severe and debilitating, and that could even be the cause of new cancers to occur within 10 or more years from their assumption.
Also, effective treatment is delayed, as even if your doctors knows well what the best treatment option for your specific condition is, your health plan cannot provide it until you take all the other obligatory steps. Many drugs actually exacerbate symptoms and cause them to worsen, keeping many people from getting any effective treatment at all as their compliance (willingness to take the drugs) is significantly reduced, especially in elderly populations and psychiatric patients.
Step therapy can mean a delay in much-needed treatment:
Step therapy can mean a delay in much-needed treatment that in several conditions may even endanger a patient’s life. Patients are often required by their plans to stay on a given medication for too long before making a switch,and the delay to use drugs originally prescribed can be very risky or harmful if patient’s condition is not promptly treated.
Many other countries employ pharmacoeconomy strategies that aim at reducing the overall burden of medications and drug usage, but the actual step therapy or “fail first” therapy as many call them, is just a monstrosity. Several European nations would consider this kind of approach as unethical, as it doesn’t just put a patient’s life to risk, but it simply makes thoroughly clear that what really matters for insurance companies isn’t the safety or the quality of life of other human beings, but only the amount of money they can make every year.
Martin is a freelancer, who enjoys writing articles about Step Therapy and it’s impacts on patients. He helps creating awareness to patients in order to prevent them from receiving ineffective treatment.