Mentorship concept Step therapy limitations may cause patients to experience delays in receiving effective treatment and encounter avoidable disease progression, prolonged pain and potentially negative long-term effects.

Health plans commonly use step therapy protocols, which require patients to try one or more alternative treatments and receive a particular drug only if they fail. This can improve the quality of care by guiding patients to drugs with better safety, efficacy and cost-effectiveness profiles.

There is a risk, however, that if health plans primarily use step therapy protocols as cost-control measures — that is, to drive patients toward cheaper treatments — patients may experience delays in receiving effective treatment and encounter avoidable disease progression, prolonged pain and potentially negative long-term effects.

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