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


Traditional step care protocols, whereby patients are required to try an older generation agent prior to obtaining approval for reimbursement of a newer one, have largely disappeared.

Currently, it is more common for payers to designate one or two preferred pharmaceuticals chosen from the newer agents. Patients must first experience a treatment failure on a preferred agent prior to being reimbursed for a non-preferred agent.

  • These practices may contribute to the perception that access is too cumbersome.
  • These practices may require switching among pharmaceutical agents within a given class (e.g., SSRIs).