Across the United States, many individuals living with schizophrenia face unnecessary delays in accessing the medications that work best for them—delays caused by restrictive step therapy policies imposed by insurance plans. Step therapy, sometimes called “fail first” policies, forces patients to try and fail on one or more medications before insurers will cover the medication originally prescribed by their provider.

This approach can be particularly harmful in the treatment of serious mental illnesses like schizophrenia, where timely access to the right medication is critical. Every patient responds differently to antipsychotics, and what works for one person may not work—or may cause intolerable side effects—for another. Yet, step therapy protocols often require patients to cycle through older or less appropriate treatments, increasing the risk of symptom relapse, hospitalization, and reduced quality of life.

In some states, these restrictions are especially severe. For example, Florida has one of the most burdensome step therapy requirements for antipsychotic coverage, mandating patients try and fail multiple medications before accessing newer options. These policies prioritize cost savings over clinical judgment and ignore the urgency of stabilizing individuals with serious psychiatric conditions.

All patients deserve access to treatments based on their individual needs—not insurance algorithms. Step therapy may be appropriate in some cases, but for those living with schizophrenia or other serious mental illnesses, it can pose unnecessary barriers to care.

One thing you can do today to support equitable access to care is sign on to a joint letter urging the Florida policymakers to eliminate step therapy requirements for antipsychotic medications. This letter brings together organizations across the mental health and research communities to advocate for policies that prioritize clinical evidence and patient well-being. If your organization would like to be part of this collective voice, you can review and sign the letter here or individuals can request more information here.