Step Therapy

Step Therapy is a game insurance companies like to play because it MIGHT possibly save them some money. When a doctor prescribes a treatment for a pain patient, insurance companies often require trial of cheaper options which must fail before moving on to the next step. Often there are many steps placed between the patient and their doctor’s prescribed treatment. This fail first process has many challenges and pitfalls for patients and puts insurance companies in the role of treatment decision maker, instead of your provider. Read on to see how the game is played in our Step Therapy Poster Project.

iPain’s position

Step Therapy practices that go unregulated create additional barriers leading people in pain to forgo needed medications. This can cause pain patients to worsen and also increases the need for medical care in the future. Costing patients and insurance companies more in the long run. These delays in care increase frustration, anxiety and depression. When fail first policies come into play the risk of non-compliance and self-medication goes up.

  • Clinicians should be able to easily override protocols if they can document reasons for doing so.
  • Insurance companies should be encouraged to conduct research into the true costs of step therapy protocols, considering utilization of other medical services as well as their impact on the pain patient’s quality of life.
  • No person with pain should be required to try an inordinate number of ineffective treatments.
  • We supports policies that limit the ability of third party payers to mandate step therapy protocols for the treatment of chronic pain.

Step Therapy Awareness Video – iPain PSA Project

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Step Therapy Poster Project. – This poster explains the pitfalls of step therapy practices by insurance companies, and offers some solutions to level up with the insurance companies.

 
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