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


Under step care programs, physicians are required to attempt to treat a patient with a designated first-line drug and document treatment failure or patient intolerance prior to using another "reserved" agent. In general it is thought that the designated first-line drug is an older, often cheaper, and perhaps less effective drug than the reserved drug. Alternatively, patients may be required to try a new-generation, formulary drug before being given reimbursement for another non-formulary, new-generation drug. Step care programs are similar to prior authorization programs in that they often serve to control prescribing practices.