Varied Use of Step Therapy Among Medicare Advantage Plans
The frequency with which 7 of the largest Medicare Advantage plans impose step therapy protocols in their Part B drug coverage decisions varies substantially.
Patients’ Access to 2018 FDA-Approved Drugs 1 Year Post Approval
2018 was a landmark year for new drug approvals. However, patients’ access to these novel drugs varied by drug category and enrolled health plan.
Variation in US Private Health Plans’ Coverage of Orphan Drugs
Health plans restrict orphan drug coverage less often than nonorphan drug coverage. However, the frequency of restrictions varies considerably across plans.
Mapping US Commercial Payers' Coverage Policies for Medical Interventions
The authors examine the largest 20 US commercial payers’ coverage policies and identify variation in how interventions are covered and the evidence reviewed in them.
The Impact of Formulary Drug Exclusion Policies on Patients and Healthcare Costs
The authors review empirical evaluations of drug exclusion policies to examine their impact on patients and on healthcare costs.