Special Issue: Pharmacy Benefits

Constraining access to HIV regimens can have significant implications for patients. This study examined the economic and health impacts of restrictive HIV formulary designs.

Adults with attention-deficit/hyperactivity disorder (ADHD) who received long-acting combination therapy had significantly lower adherence and persistence compared with those who received long-acting monotherapy.

By covering vaccinations under both the medical and pharmacy benefit, rather than the medical benefit alone, health insurers can help improve adult vaccination rates.

Patients with rheumatoid arthritis who switched biologics incurred higher costs than patients who persisted on biologics. Etanercept appeared to be associated with the lowest costs.

Adherence to newly initiated biologic therapy for rheumatoid arthritis is important for long-term adherence.

Direct oral anticoagulants (DOACs) are associated with increased prescription costs. Actual practice data show a high switch rate and poor adherence among DOAC initiators that need to be addressed.

A 5-aminosalicylic acid (5-ASA) drug switch program switching from 5-ASA to sulfasalazine was instituted for insured patients with ulcerative colitis. Unanticipated barriers limited the number of patients who switched, but significant cost savings were still obtained.

Findings from a literature review indicate that overall costs of long-acting insulin analogues are not significantly different from those of intermediate-acting human insulin and oral antidiabetic agents.

This decision tree model estimates the cost per response and incremental cost per additional responder for romiplostim, eltrombopag, and “watch and rescue” for immune thrombocytopenia.

Only slightly more than half of patients with newly diagnosed rheumatoid arthritis initiated therapy within 1 year.

Most non–inborn errors of metabolism (non-IEM) medical foods (MFs) do not meet the regulatory MF definition and lack scientific evidence for safety and efficacy. Non-IEM MFs are not yet ready for reimbursement by public insurers.