Drug classes requiring step-therapy

Priority Health has some drug categories that require a therapeutic trial of a specific drug(s) before authorization will be granted for other medications. This process is commonly referred to as step therapy.

Here are some examples of common drug classes for the commercial formulary (HMO, PPO, POS) that require step therapy:

Angiotensin receptor blockers:
Requires the documented therapeutic trial and clinical failure of a generic ACE-Inhibitor or ARB.

Antidepressants:
Requires the use of one generic antidepressant before a claim for Lexapro or Cymbalta is allowed.

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