Step Therapy Program
Step Therapy is a program especially for people who take prescription drugs regularly for ongoing conditions like arthritis, asthma and high blood pressure. It helps you get an effective medication to treat your condition while keeping costs as low as possible. Step Therapy requires you to first try certain drugs to treat your medical condition before another drug will be covered.
For example, if Drug A and Drug B both treat your medical condition, the Fund may not cover Drug B unless you try Drug A first. If Drug A does not work for you, the Fund will then cover Drug B. In this example, Drug A is the first step in the step program and is usually a generic drug. These drugs should be tried first because they can provide the same health benefit as brand-name drugs but at a lower cost. Drug B is considered a back-up drug (Step 2 and Step 3 drugs). These are brand-name drugs, such as those you see advertised on TV, and their costs are based on the Step number (i.e., Step 2 drugs tend to cost less than Step 3 drugs).
Examples of typical therapeutic classes and medicines that require Step Therapy include, but are not limited to: Proton Pump Inhibitors (like Prevacid/Nexium), statins for cholesterol, sleep aids, SSRI/SNRI antidepressants, nasal sprays, osteoporosis medications, ARB antihypertensives and combination antihypertensive, Lyrica, Nasal Sprays, Overactive Bladder, Tekturina, Glaucoma Agents and Migraine Medications.
For a complete list of medications, or if you have questions about Step Therapy, contact Sav-Rx at 1-866-233-IBEW.