The high cost of incretin mimetics for weight management limits insurance coverage and potentiates variation in utilization management strategies to control near-term spending.
Altruism values for treatments of rare, severe pediatric diseases have not been estimated. This study found the altruism value for a hypothetical new Duchenne muscular dystrophy treatment to be $80 per year.
The authors used medical loss ratio forms to assess trends in premiums, medical claims, administrative costs, quality improvement, and margins in the large group insurer market.