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Context Florida: Better & Efficient Care, Not Red Tape

As a rheumatologist, I treat relatively common problems, such as osteoarthritis, osteoporosis, and rheumatoid arthritis.  Other individuals have rare conditions shared by only a few people in the U.S.

When I am able to bring relief to my patients, my day has been successful.  Two protocols used by insurance companies to reduce their costs — prior authorization and “fail first” — place a heavy burden on physicians and unnecessarily interfere with our ability to provide timely effective treatment.

“Fail first” or step therapy protocols require a patient to try the least expensive therapy first, despite what his or her physician recommends.  After failing on the least expensive option, patients can finally receive what their physician originally prescribed.

These protocols can cause harm.  For example, patients with chronic conditions, such as diabetes, mental illness, autoimmune, or cardiovascular disease, require proper drug treatments to stabilize their condition.  Without these treatments, these patients will need more costly treatments such as hospitalization and can incur potential permanent organ damage and disability.

Read the full story at Context Florida.