- Center on Health Equity & Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
Cost Savings More Important for Payer Committees than Clinical Concerns
Pharmacy and therapeutic committees view potential cost savings as the most important factor when recommending formulary placement, according to a new survey.
With rising prescription drug prices challenging payers, how are their key decision makers adjusting their approach to recommending coverage for medicines?
A new survey finds that pharmacy and therapeutic committees, whose job it is to assess the clinical effectiveness of new drugs, view potential cost savings as the most important factor when recommending formulary placement. A formulary is a list of drugs that receive preferred coverage.
On a scale of one to six, potential cost savings of a drug ranked highest, at 3.8. This priority edged out the overall safety and efficacy of a drug relative to directly comparable medicines, at 3.7, according to the survey of P&T committees conducted by Barclays Bank analysts.
Read more at The Wall Street Journal: http://on.wsj.com/1H1vYkb
Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
Listen
For Neuromuscular Disease Community, an Era of Opportunities and Threats
March 17th 2025Robert Califf, MD, former commissioner of the FDA, delivered a keynote address at the 2025 Muscular Dystrophy Association Clinical & Scientific Conference that highlighted the enormous opportunities for progress in neuromuscular disease care amid a changing policy environment.
Read More
The Impact of Cost Sharing on High-Value Care
March 14th 2025Michael Chernew, PhD, professor of health care policy and director of the Healthcare Markets and Regulation Lab, Harvard Medical School, shares how cost-sharing policies shape access to critical health care services and influence value-based insurance design.
Read More
Oz Confirmation Hearing Probes Vision for Medicaid but Coalesces Around Well-Being
March 14th 2025Mehmet Oz, MD, the nominee to lead CMS under the Trump administration, testified in a confirmation hearing before the Senate Finance Committee, where he found common ground on improving outcomes through healthier lifestyle choices but encountered repeated questions on potential Medicaid cuts.
Read More
