- Center on Health Equity & Access
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- Value-Based Care
Segment 2: Rational Drug Use
While formularies should provide physicians the ability to treat any patient that walks into the office, there also need to be clinical exceptions that allow patients with mitigating circumstances to get any product clinically necessary.
While formularies should provide physicians the ability to treat any patient that walks into the office, there also need to be clinical exceptions that allow patients with mitigating circumstances to get any product clinically necessary, said Steven Miller, MD, MBA.
“Clearly doctors and patients would like unfettered access to all products, but we know that the economic reality resulting in that would be much, much higher drug costs,” he said.
Keith Hoffman, Phd, would like to see more analysis of post-marketing adverse event data included in formulary decisions.
“The ramifications for patient safety are not all the way figured out prior to the release of the drugs,” he explained.
Price Transparency With Gaps: Assessing the Completeness of Payer Transparency in Coverage Data
December 9th 2025In analyzing 2025 Transparency in Coverage (TIC) files from national insurers, the authors found vast payer-level differences; overall, physician/outpatient data were more complete, and hospital inpatient data were less complete.
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