Step Therapy: Why You Can't Get The Medications You Need-When You Need Them

“My doctor wanted me to try Benlysta, a drug that is FDA approved to treat lupus; however, my insurance denied the approval for the medication. They said I had to “try and fail” other off-label medications like Iruman and methotrexate. One medication made my white cells tank, the other made my hair fall out, and neither helped my lupus.” -Lupus Patient

What Is Step Therapy

Step therapy, or the “fail first” requirement, is a process used by health insurance companies to control costs. Like the name sounds, step therapy creates additional “steps” that a patient needs to take before he or she can attain th