Step Therapy is a program designed to encourage the safe and cost-effective use of medication. Organized into a series of steps, the program requires the member to try a “first-line medication” before a “second-line medication” will be covered through the prescription drug plan. First-line medications are widely recognized as safe and effective in treating a specific medical condition. Second-line medications are either preferred or non-preferred brand-name drugs, and are generally more costly. When possible, a provider should prescribe a first-line medication appropriate for a condition. If he or she determines that a first-line medication is not appropriate or is not effective in treating a condition, the prescription drug benefit will cover a second-line drug.
Note: Lists are subject to change throughout the year.