Payer Transparency Reforms: Moving From Rebates To Drug Access Restrictions
Institute for Clinical and Economic Review analysis of whether payers are providing ‘fair access’ to fairly priced drugs was hampered by a lack of transparency among payers, leading to calls for reform.
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Step Therapy: As Bill Aims To Routinize Processes, Study Finds Policies Often Stricter Than Clinical Guidelines
Chronic migraine and anti-inflammatory treatments were most often subject to step therapy, Tufts researchers found. Policies varied from payer to payer, raising concerns over the impact of shifting requirements for treating the same disease as patients move among insurers.
The most detailed US reporting requirements regarding prescription drug costs and coverage will target medicines reimbursed under the retail pharmacy benefit.
Study will look at prior authorization, step therapy and required medication switching for drugs considered to be reasonably priced.