Step Therapy
Step therapy, also known as 'fail first', is a practice used by health plans to control costs. Step therapy prevents patients from accessing a treatment prescribed by their physician by requiring them to try one or more alternative treatments first. Once those treatments have been proven ineffective or harmful to the patient, then they can step up to the treatment originally prescribed by the physician.
AiArthritis Position Statement On Step Therapy
Step therapy forces patients to fail on often inferior, lower cost drug therapies preferred by health plans instead of the therapies prescribed by their physician. For many patients, delaying access to the most clinically appropriate care can lead to adverse, severe, and more costly health outcomes, including irreversible disease progression
Patient Written Glossary of Terms
Frequently, everyday terms when navigating a diagnosis of an AiArthritis Disease—such as "payer"—can lead to confusion. Therefore, we have developed a glossary to assist!
Discover Patient Journeys Through Step Therapy In Our Video Library!
The Patient-Instructed Video Library
The Patient-Instructed Video Library was created to help our community gain a deeper understanding of critical issues that affect access to health care. The goals of this initiative are to educate, inspire fellow patients to share their experiences, and empower our community to take action in addressing access-related challenges.
What is Step Therapy? (Jody's Perspective)
Jody AiArthritis Volunteer and person living with Psoriatic Arthritis, as she explains the definition of Step Therapy.
Step Therapy - Why Should Patients Care? (Jody's Perspective)
Jody discusses why patients should understand Step Therapy and how the process may impact your access to treatments prescribed by your doctor and based on your personalized needs.
Step Therapy - Why Should Patients Care? (Lisa's Perspective)
Lisa, AiArthritis Volunteer and person living with Rheumatoid Arthritis, explaining what Step Therapy is and how the process of delaying the treatment the doctor feels is best for you could lead to severe complications (like comorbidities) and, in turn, higher healthcare costs
Example of Step Therapy: (Leila's Perspective)
Leila, AiArthritis Education and Engagement Manager and person living with Lupus Nephritis and Sjogren's Syndrome, sharing an example of Step Therapy and how you can know if it's happening to you or someone else you know.
Step Therapy Patient Story: Abby's Perspective
Abby, an AiArthritis volunteer and a person living with Rheumatoid Arthritis and Spondyloarthritis, shares her struggles with step therapy. From advocating in Washington DC to confronting the rigid insurance system that stood between her and the right treatment.
Step Therapy Patient Story: Tiffany's Perspective
Tiffany, AiArthritis CEO and person living with non-radiographic Axial Spondyloarthritis, shares her journey through step therapy and utilization management. Tiffany opens up about her struggles with non-medical switching due to cost and the negative impacts this had on her health.
Step Therapy Patient Story: Jody's Perspective
Jody, an AiArthritis volunteer and person living with Psoriatic Arthritis, shares her journey and challenges faced with step therapy. Jody's journey reveals weeks of delays, denials, and even an incorrect review by a non-rheumatologist, causing her significant joint damage and reduced work hours.
Step Therapy Patient Story: Deb's Perspective
Deb, an AiArthritis volunteer and person living with Rheumatoid Arthritis, shares her story of step therapy and being denied access to a higher tier medication which she had successfully been on.
Learn More By Exploring Our Video Library
Did you know that access to healthcare and treatments is frequently tied to policies like government healthcare systems and insurance companies? Recognizing these influences and sharing YOUR experiences with legislators to illustrate the need for policy change is crucial!
Share Your Step Therapy Experience
Would you share your experience with us? We’d like to hear how you navigated challenges in obtaining healthcare or treatments. What obstacles did you face, and how have they shaped your journey? Your insights could be invaluable to others in similar situations.
Class Is In Session! Step Therapy
About The Classroom: Lead instructors, including our CEO Tiffany, who has non-radiographic axial spondyloarthritis (nr-axSpA) and is a former award-winning college instructor, will collaborate with Class Discussion Leaders living with our diseases to host engaging webinars and AiArthritis Voices 360 Talk Show segments.
Step Therapy Class: Most have experienced this health insurance protocol that requires us to fail a cheaper drug before being allowed to access the one prescribed by our doctor. Learn more about this issue & what you can do if it happens to you. In collaboration with The National Psoriasis Foundation
How To Get More Involved!
Ready to deepen your involvement? Share experiences to support our fight for change with AiArthritis—join us for co-writing letters, virtual Field Trips, or become an inaugural AiAdvocate in our policy leadership program!
Join the Knowledge = Empowerment Program
A virtual, patient-led classroom approach designed to help patients understand legislative issues affecting treatment access and connect them with opportunities to advocate for change.
#WTHellth?!
Share your frustrations with the healthcare system using #WTHellth. Prefer privacy? Submit a written rant anonymously through AiArthritis’ RANT! program, selecting the #WTHellth category.
