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Exploring Payer Coverage Decisions Following FDA Novel Drug Approvals
On this episode of Managed Care Cast, Ari D. Panzer, BS, lead author and researcher, then at Tufts Medical Center—now at Duke University—discusses the findings from his team’s investigation into coverage decisions by health plan insurers of the 66 drugs approved by the FDA in 2018.
In 2018, the FDA approved a record 66 novel drugs. Among them were cancer treatments, orphan drugs for rare diseases, drugs under expedited review, and biosimilars. However, access to each of these drugs for patients covered by different health plans was not uniform.
On this episode of Managed Care Cast, we speak with Ari D. Panzer, BS, a master of public policy candidate at Duke University, and lead author of “Patients’ Access to 2018 FDA-Approved Drugs 1 Year Post Approval,” which was published in the April issue of The American Journal of Managed Care®. He delves into why it’s important to ensure patients receive optimal treatment and maximize their outcomes, understanding why health plans vary in their coverage decisions despite having access to the same evidence, and the difficulty of striking the right balance between drug access, cost, and coverage to ensure patients can get the drug therapies they require when appropriate.
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Insurance Payer Is Associated With Length of Stay After Traumatic Brain Injury
February 21st 2025Among hospitalized patients with traumatic brain injury, Medicaid fee-for-service was associated with longer hospital stays than private insurance and Medicaid managed care organizations.
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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.
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Abortion in 2025: Access, Fertility, and Infant Mortality Updates
February 20th 2025While Republican state-led efforts aim to increase restrictions to abortion care and access to mifepristone and misoprostol in 2025, JAMA authors join the conversation with their published research and commentary.
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