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Palm Beach Post: Michael Ruppal: Physicians need to focus on patients, not red tape

Physicians who treat HIV and AIDS patients work very hard to ensure their patients are receiving the most appropriate medication, only to be forced to fail first on another medication that increases their risk of suffering from negative side effects — or even being hospitalized.

Patients with HIV and AIDS require certain medications that are critical to ensuring quality of life. Prescription drugs may be classified in the same “class,” but this does not guarantee that the effect on the patient will be comparable.

“Step therapy,” or “fail first,” is a process that insurers use to deny patients their prescribed medication. It requires them to try, and fail, on at least one less expensive medicine before they are approved for the prescribed medicine.

In some instances, there will be no repercussions from taking a generic or less expensive brand. But for patients with HIV and AIDS, this can be the difference between being healthy or being hospitalized. There needs to be a way for patients, with certain medical needs, to bypass these steps if following them could cause patients significant health problems.

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