Imagine being diagnosed with a degenerative illness—and then being told you can’t access the medication your doctor prescribed until you fail on a cheaper one first.

That’s what happened to Serena Hostvet, an artist from Wisconsin living with multiple sclerosis (MS). Her doctor prescribed a drug to prevent painful and possibly permanent relapses. But her insurance company made her try two cheaper medications first—both of which caused dangerous side effects and vision loss.

Only after months of denials and appeals did her insurer finally approve the treatment she needed. But by then, the damage was done.

This isn’t rare. It’s a process called step therapy, also known as “fail first.” Insurance companies force patients to try and fail on cheaper medications—even when doctors warn they may be less effective or risk harmful side effects.

This practice delays care, puts lives at risk, and undermines the medical judgment of doctors treating patients with serious illnesses like:

Multiple sclerosis
Cancer
Epilepsy
Lupus
Crohn’s disease
Rheumatoid arthritis
…and more.

We are calling on Congress to immediately pass legislation to ban step therapy for patients with chronic, progressive, or life-threatening conditions. Doctors—not insurers—should decide what treatment is best.

No one should be forced to "fail first" when every day without proper care could mean permanent damage or death.

Tell Congress: ban fail-first policies for good. Stand up for patients, for dignity, and for the basic right to access the care your doctor says you need.

Photo: NBC News