In Cheaper Medicines Not Always Better, medical expert Peter Pitts, President, Center for Medicine in the Public Interest and former associate FDA commissioner writes:
Yet some policies that are gaining popularity are weakening the doctor-patient relationship by putting treatment decisions in the hands of third parties.
Chief among these schemes is “step therapy.” Also called “fail first,” this is a policy that is sometimes adopted by insurers and government health programs to save money on pharmaceuticals. It forces patients to try cheaper alternatives to a prescribed drug before they are permitted to get the medicine that their physicians ordered.
So even though a doctor might recommend drug A to treat a patient’s hypertension, an insurance company or government program would require the patient first try cheaper drugs B and C, and only after the cheaper drugs are shown to be ineffective can the patient receive the medicine his doctor recommended.
For more, see Orange County Register.