- Step therapy
In managed medical care step therapy is an approach to prescription intended to control the costs and risks posed by prescription drugs. The practice begins
medication for a medical condition with the most cost-effective and safest drug therapy and progresses to other more costly or risky therapies only if necessary. Also called step protocol, a fail first requirement, or a prior authorization requirement.Recent trends in prescription drug prices in the United States has led to an increased pressure on health care providers to keep down the cost of prescription medication while maintaining high levels of availability to the patient [ Jessica S. Banthin, Peter Cunningham, and Didem M. Bernard "Financial Burden Of Health Care", 2001–2004 Health Affairs, January/February 2008; 27(1): 188-195. ] . The use of
generic drugs when possible allows health care plans to pursue both of these goals effectively [ [http://www.ajmc.com/Article.cfm?Menu=1&ID=2650 Brenda R. Motheral, PhD; Rochelle Henderson, MPA; and Emily R. Cox, PhD "Investigation showing step therapy reduces managed care costs: Plan-Sponsor Savings and Member Experience With Point-of-Service Prescription Step Therapy", The American Journal of Managed Care Volume 10:457-464 July 2004 Number 7 Pt 1] ] . Physicians and managed care providers may disagree on the proper step therapy [Neil J. MacKinnon, Ph.D., R.Ph., Ritu Kumar, M.H.S.A., R.N., "Prior Authorization Programs: A Critical Review of the Literature", Journal of Managed Care Pharmacy 2001 Volume 7 Issue 4:297-303 ] and patients are encouraged to become knowledgeable in managing their own care.Notes and References
Further Reading
* [http://www.amcp.org The Academy of Managed Care Pharmacy] - Hosting the Journal of Managed Care Pharmacy
ee Also
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Prescription drug
*Prescription drug prices in the United States
*Managed Care
*Health care in the United States External Links
*PDFlink| [http://www.amcp.org/data/nav_content/Prior%20Authorization%20-%20Memohead%20-%20Corrected.pdf "The Academy of Managed Care Pharmacy’s Concepts in Managed Care Pharmacy: prior authorization"] |84 KiB
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