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. The use of generic drugs when possible allows health care plans to pursue both of these goals effectively. Physicians and managed care providers may disagree on the proper step therapy and patients are encouraged to become knowledgeable in managing their own care.