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NAMI believes that all people with mental health conditions deserve access to effective medication and treatment options. NAMI supports public policies and laws that prohibit step therapy for psychiatric medications.
Mental health medications affect people in different ways, and individuals need to be able to access the medication that works best for them and their individual health needs. It is important that medication decisions are carefully considered with a health care provider who has both extensive knowledge of the individual and available medication options.
Sometimes, health insurers may request or require patients to demonstrate unsuccessful treatment on one or more insurer-preferred medications before they receive coverage for the medication that their physician recommends. This practice is also known as “step therapy” or “fail first,” meaning that an individual must “fail” on one or more medications before they can try another that may be recommended by their health care provider. Step therapy results in patients not being able to access the treatments they need in a timely manner.
Step therapy can be a danger to the health and well-being of the person taking the medication, and result in a worsening of symptoms and undermining the decisions made between individuals and their health care providers. Instead, policies should maintain access to provider-recommended medications and should specifically prohibit step therapy for psychiatric medications, or, at a minimum, establish clear, rapid timelines for insurer responses to requests for exceptions and ensure that people who have previously used a medication do not have to switch.
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