Should fail-first medical treatments be encouraged?
As an emergency-room physician, providing the best possible care to my patients as efficiently as possible is key to their health. The health care system is complicated and expensive — getting quality medical care when you need it shouldn't be.
Recently, the Centers for Medicare and Medicaid Services announced that Medicare Advantage Plan Holders will no longer be protected from insurance-company-implemented Step Therapy. I do not support Step Therapy, because it requires physicians to prescribe drugs preselected by the insurance company first. Patients are only allowed to move on to potentially more effective treatments after the insurance-company-chosen drug fails them. Medical professionals being unable to give patients the right treatments first, and on time, has human and economic costs that are unacceptable.
With Step Therapy, treatment plans are no longer controlled by a patient's doctor, but are dictated by insurance companies. In fact, Step Therapy has become known as "fail-first" treatment because patients must first try and allow treatments to fail before being given the option to move to more effective treatments. Under Step Therapy, insurance companies are directly interfering with doctor-patient relationships.
There are already enough complications and delays in our health care system. We should not be implementing policies that require a fail-first approach, prolonging treatment and ultimately recovery.
Dr. Jack Rosoff
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