Step therapy is a familiar cost-control measure in which payers have patients test out lower-price medications before granting approval for higher-priced ones, in the hope that cheaper interventions can achieve the same goal.

A study published in Arthritis Research & Therapy and reported on by Medpage Today indicates that this approach may have a downside among psoriatic arthritis patients. The study found that patients were more likely to stop taking their psoriatic arthritis medication if non-biologics were their first treatment, but were more likely to stick with a treatment regimen if biologics were their first prescription experience.

The retrospective analysis of insurance claims could not determine why patients stopped their medications, but researchers did find that 79% of patients taking an oral non-biologic disease-modifying anti-rheumatic drug stopped the drug prescribed, 25% switched and 30% added on a treatment. In contrast, patients who started on biologics had a 92% adherence rate after one month, 80% after three months and 54% stuck with therapy after a year.