Balancing great patient care with cost management is perhaps the biggest challenge in today’s health care system. One tool used by government and private insurance plans alike to try to limit costs is known as “step therapy.”

Under this practice, insurers will sometimes require a patient to try other, more common medications before approving the one a doctor prescribes. The hope is that the patient will respond to less expensive medication without the need for more specialized, more costly treatment.

But “step therapy” is dictated by medications an insurer covers, not a patient’s medical condition or a physician’s advice.