Fail First, also called step therapy, is an approach to prescribing drugs that insists that the least expensive drug in any class be given to a patient first.  If it works, then ... good!  If not, then the next least expensive drug must be tried ... and so forth.
Fail First is used by health insurers to control costs.  It is time-consuming from a physician and patient standpoint, is more expensive from a direct and indirect out-of-pocket cost perspective, denies patients the drugs they need when they need them, and allows payers to practice medicine without a license.
Creates barriers leading people to receive less of needed medications.
Can cause patients’ medical conditions to deteriorate, increasing the need for medical intervention in the future.  As a result, patients require increasingly costly medical care.
Increases frustration and incidents of depression.
Increases the risk of non-compliance and self-medication.

Dr. Laurie Ferguson
explains Fail First's
emotional impact on patients.

 

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