CurrentIndependent HealthPolicy N/A

STEP THERAPY CRITERIA

Step therapy protocols for Pharmacy Benefit Dimensions Prescription Drug Plan (PDP) Part D 3 Tier Formulary current as of March 1, 2026, listing prior-therapy requirements for specific products. Governs which prior drugs must be tried before coverage is allowed for listed products.

Policy Summary

PayerIndependent Health

PolicySTEP THERAPY CRITERIA

Policy CodePolicy N/A

Change TypeClarified step therapy requirements

Effective DateMar 1, 2026

Next Review DateN/A

Key ActionPrescribers must document prior prescription history showing the required step drug(s) (e.g., ARB for aliskiren, allopurinol for febuxostat, clobazam suspension for Sympazan, Lupron Depot for Trelstar, clozapine ODT for Versacloz, calcitriol for doxercalciferol) to obtain coverage for the listed products.

SourceLink

POLICY UPDATE CHANGES

Step therapy list current as of March 1, 2026 with specified prior-therapy requirements for listed products.

18Products with step requirements listed

1Formulary referenced (PDP Part D 3 Tier)

Summary of changes and scope

Independent Health (Pharmacy Benefit Dimensions PDP) uses step therapy to require trial of specified agents before covering alternative products. This bulletin lists per-product prior-therapy requirements for the 2026 Pharmacy Benefit Dimensions Prescription Drug Plan (PDP) Part D 3 Tier Formulary, and the step therapy list is current as of March 1, 2026.

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