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Health care journalists covering addiction, overdoses, and the heroin epidemic are likely to learn that the health insurance system appears to be part of the problem. That’s what Terry DeMio found on her beat in southern Ohio and northern Kentucky. Since January 2016, DeMio has been the Cincinnati Enquirer’s heroin epidemic reporter.
Rather than paying for the best medications for drug addicts in need, health insurers often require patients to start with the lowest-cost drugs. Then if the lowest-cost prescription fails, insurers then pay for the next highest-cost drug. Called fail-first or step therapy, this process repeats until the patient finds the one that works. Meanwhile, the patient suffers or could die, DeMio said.
Here are some resources for covering this growing topic.
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