Access and Utilization of New Antidepressant and Antipsychotic Medications. D. Step Care


A principal finding of this study is the absence of traditional step care protocols, whereby patients are required to try an older generation agent prior to obtaining approval for reimbursement of a newer one. This situation represents a shift from the situation several years ago, where trial of either a tricyclic antidepressant or a typical antipsychotic was more routinely required prior to the approval of the dispensing of a new-generation agent.

It is more common, however, that providers or patients demonstrate a failure on at least one new-generation formulary drug, prior to being reimbursed for a non-formulary agent. Although this procedure does not represent full and open access to every FDA approved drug, it is consistent with open access to the newest and most-up-to-date treatment modalities.