Step Therapy

I started having symptoms of Juvenile Rheumatoid Arthritis at just 14 years old. I knew something was wrong when I started having swelling in my knee. It took two years of misdiagnoses and treatments before being diagnosed with juvenile rheumatoid arthritis.

As a teenager I went from managing my academic and social calendar to also managing an incurable chronic illness. By graduation, my arthritis had spread to over 5 joints affecting my hands, knees, ankles, and feet. As I started college, I also started weekly injections and a collegiate soccer career. I was told by many that maintaining my health and athletic career would be impossible. Improbable and difficult it was, but impossible it was not. I finished college as a two-sport athlete, later also joining the cross-country team. Ten years later, I am still competing in endurance events.

Over the years my disease has changed, and I have had to adapt my treatment plan. The most difficult part of controlling my illness has always been finding effective medication. I have accomplished so much and overcome many hardships in my life because of my physicians and effective medication. Living life with a chronic illness comes with so many challenges but having access to doctor-recommended medication should not be one of them. Unfortunately, it is.

Step Therapy is a requirement used by an insurance company to try lower cost medications that they would prefer to pay for before covering the medication your physician recommends.  Insurers often do this as a cost saving measure. For a person with rheumatoid arthritis like me, this means suffering with the pain of rheumatic flares, my body deteriorating, and destroying itself from the inside out, and a diminished quality of life while waiting to “step up” to medication my provider originally prescribed.

The doctor-patient relationship is based on trust and with an ethical responsibility to place the patients’ welfare over any self-interest. It is unethical that the insurance companies are not held to the same standards and can take medical decisions away from physicians.

Now more than ever, we need you to share your story to reform burdensome Step Therapy practices. When we take action, our joint efforts can make a significant difference. Whether you have experienced step therapy firsthand or not, your personal story helps legislators understand the challenges people with arthritis face every day. Please help us reform Step Therapy today by taking action so that patients like me don’t suffer needlessly.

Written by Jeanine McGuire, Ambassador from Pittsburgh, PA





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