Patient Access of Florida

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News-Press: Patients need the right medicine at the right time

More than 15 years ago, I was diagnosed with Hepatitis C. While the disease has created a number of challenges, one particularly frustrating and troublesome problem has been obtaining coverage for medications that my physicians have prescribed because I’ve been forced into fail first, or step therapy, protocols.

Fail first protocols are management processes used by health plans that require a patient to try the least expensive treatment of medication to address a problem, despite what his or her physician recommends. Only after trying and failing on the least expensive option, and possibly additional treatments, can a patient receive coverage for the medication the physician originally prescribed.

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