ESCAPE SYSTEM
THE
Step therapy isn’t a therapy at all. It is an insurance company tactic that often requires you to try one or more drugs before getting the medicine that your doctor prescribed.
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:
1
Require that step therapy policies are clinically based on current evidence and used for medical reasons only.
2
Prohibit switching of medication for non-medical reasons without the prescribers’ consent.
3
Leave the final decisions to whether a patient has failed on a therapy with the treating physician, not the insurer.
4
Pass rebates, discounts, copay assistance, and other insurer and non-insurer savings directly to the patient at the pharmacy counter.
5
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.
Patient/Physician Stories
Hear from patients and physicians who have experienced these roadblocks first-hand.
OVERVIEW
As part of our Escape the System virtual exhibit, you can experience the frustrations caused by the inappropriate use of step therapy.
STAY TUNED TO THIS PAGE TO LEARN MORE ABOUT STEP THERAPY AND OTHER ACCESS RESTRICTIONS.
KNOWLEDGE IS POWER AND WE CAN ALL MAKE A DIFFERENCE TOGETHER.
RESOURCES
Patient Guide
Escape the System Brochure
Autoimmune Association COVID-19 Page
National Scorecard
INSIGHT: Conversations with Thought Leaders - Dr. Neil Nandi & Lilly Stairs
Escape the System: Randall Rutta
