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Latest From OptumRx Inc.
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.
Oncology drugs are no longer immune to pharmacy benefit management formulary exclusions in the commercial market and even drugs administered in a physician’s office are increasingly being subjected to rebate-driven coverage decisions.
Study will examine prior authorization and other access restrictions at 15 of the largest US commercial payers for a group of 27 drugs.
Study will look at prior authorization, step therapy and required medication switching for drugs considered to be reasonably priced.