Need a new, better drug to tackle a serious illness? In Canada, you have to 'fail' on an old drug first

In Canada, “fail-first” drug policies—also called step therapy—can delay access to newer, more effective treatments until older options are shown not to work. The issue is illustrated through Crohn’s and Colitis Canada CEO Josh Berman, diagnosed with ulcerative colitis in 2021, who says he only regained his life about six months ago after proving earlier prescribed medication didn’t work. Another example involves stagehand Will Florence, whose epilepsy cannot be controlled with medication; he needs vagus nerve stimulator implant surgery and, like Berman’s case, must first demonstrate that existing treatments fail. The article explains that provincial health plans require older, cheaper therapies before approving newer, costly drugs.