The Massachusetts House passed a bill which aims to curb the use of step therapy by health insurers. Drugs that are designated with a “step therapy” condition of reimbursement are only paid for by ...

Management tools are intensifying across markets, including more prior authorization, step therapy, formulary exclusions, and biosimilar preferencing, with spillover from Part D into commercial ...

Step therapy is when Medicare Part D plans ask beneficiaries to try a more affordable drug before approving higher-cost prescriptions. In Medicare, Part D covers general prescription drugs, whereas ...

To keep rising health-care costs in check, many health insurers have adopted a strategy known as "step therapy," a policy requiring patients to try cheaper drugs first—and find them to be ...

Panelists discuss the challenges and evolving landscape of step therapy protocols in hidradenitis suppurativa treatment, emphasizing the impact on patient adherence, the potential benefits of earlier ...

The frequency with which 7 of the largest Medicare Advantage plans impose step therapy protocols in their Part B drug coverage decisions varies substantially. Objectives: First, to examine 7 large ...

Over the past two decades the use of step therapy or edits by health insurers has increased significantly. Step therapy, also called step edits, implies that in a given therapeutic class lower cost ...

As science makes once-unthinkable treatments available, patients are increasingly facing a harsh reality: Insurance companies are forcing them to try older, less expensive therapies for months before ...

Every day Melissa Fulton, RN, MSN, FNP, APRN-C, shows up to work, she's ready for another fight. An advanced practice nurse who specializes in multiple sclerosis care, Fulton says she typically spends ...

Have you ever gone to pick up a new prescription medication, only to be told your insurance plan won't cover it until you try a different medication first? This requirement is an insurance limit known ...

For roughly half my life, I have suffered from debilitating joint pain and inflammation that left me drained, fatigued, and, eventually, struggling to walk. At first, no one knew what was wrong with ...