Step Therapy

Step-therapy is a key part of our prior-authorization program, and it helps us provide you with appropriate and affordable drug treatments. The following describes how step-therapy works:

  • If you're diagnosed with hypertension, you may be required to try a medication that is considered a first-step therapy, like lisinopril, before trying a medication that is considered a second-step therapy, like Avapro.

    • Often, first-step therapies are more affordable generic drugs

    • Second-step therapies, like Avapro or Diovan are frequently more expensive than brand-name drugs

  • If you've already tried a first-step medication and your doctor prescribes a second-step medication, coverage for that second-step alternative is automatically approved in most cases.

  • If your prescription records do not indicate the use of a first-step medication, or if you are a newly enrolled member with no prescription history, your physician may contact us directly to request an exception to the step therapy program.

View a list of step-therapy medications