At Let My Doctors Decide, we are calling on insurers and pharmacy benefit managers (PBMs) to adopt our Patient Principles and eliminate disruptive step therapy protocols that exacerbate the problem. The LMDD Patient Principles that put patients first are:
Require that step therapy policies are clinically based on current evidence and used for medical reasons only.
Prohibit switching of medication for non-medical reasons without the prescribers’ consent.
Leave the final decisions to whether a patient has failed on a therapy with the treating physician, not the insurer.
Pass rebates, discounts, copay assistance, and other insurer and non-insurer savings directly to the patient at the pharmacy counter.
Assure that what is best for the patients’ health is the top priority and is made transparent in health care contracting, including benefit design and coverage policies.
Hear from patients and physicians who have experienced these roadblocks first-hand.
Beyond my regular digestion issues, my joints began to stiffen and swell. The nerve endings in my feet sang out in excruciating pain after each step. I needed help, and fast.