Step therapy is a treatment approach often required by health insurers to control costs. It involves treating first with a lower-cost medication and, only if that proves ineffective, switching to another, more costly medication. Although step therapy is commonly applied in treating hypertension, diabetes, cancer, and other conditions, concerns regarding its potential for long-term harm to the patient have led some to view it as “fail first” therapy.1,2 One valid criticism of step therapy is a lack of an evidence base for its efficacy and safety. In this issue of the Journal, Jhaveri, Glassman, and colleagues3 describe a rigorous trial . . .
Funding and Disclosures
Disclosure forms provided by the authors are available with the full text of this editorial at NEJM.org.
This editorial was published on July 14, 2022, at NEJM.org.
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