Patient Access of Florida

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Tampa Tribune: Patients need the right medicine at the right time

More than 15 years ago, I was diagnosed with Hepatitis C. Although 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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