It is a type of prior authorization requirement that is intended increase insurance company profits at the expense of patient health by forcing patients onto lower cost prescription drugs.
The increase in prescription drug prices in the United States has increased the pressure on health care providers to keep down the cost of prescription medication while maintaining high levels of availability to the patient.
[1] The use of generic drugs whenever possible allows health care plans to pursue both goals effectively.
[2] Physicians and managed care providers may disagree on the proper step therapy,[3] and patients are encouraged to become knowledgeable in managing their own care.
It is time-consuming from a physician and patient standpoint, is more expensive from a direct and indirect out-of-pocket cost perspective, denies patients the drugs they need when they need them, and allows payers to practice medicine without a license."