• Center on Health Equity and Access
  • Clinical
  • Health Care Cost
  • Health Care Delivery
  • Insurance
  • Policy
  • Technology
  • Value-Based Care

Exchange Plans Pose More Prescription-Use Barriers

Article

Patients covered by exchange-based insurance are more likely than those in employer-sponsored plans to face utilization management controls-such as prior authorization and step therapy-in filling their prescriptions, a report Monday from healthcare consultancy Avalere Health contends.

Patients covered by exchange-based insurance are more likely than those in employer-sponsored plans to face utilization management controls—such as prior authorization and step therapy—in filling their prescriptions, a report Monday from healthcare consultancy Avalere Health contends.

In the mental health category, 50% of drugs were covered without utilization management in employer-sponsored plans versus 15% in exchange-based plans, according to Avalere's data. Also, 27% of oncology drugs were covered without utilization management in employer-sponsored plans, compared with 16% in exchange-based plans. The majority of HIV/AIDS drugs—60%—were covered free of utilization management in exchange-based plans, but that number still paled in comparison to patients with employer-sponsored insurance.

Read the full story here: http://bit.ly/1ljylXl

Source: Modern Healthcare

Related Videos
Mila Felder, MD, FACEP, emergency physician and vice president for Well-Being for All Teammates, Advocate Health
Sarah Bajorek, PhD, BCACP, MBA.
Pat Van Burkleo
Video 11 - "Social Burden and Goals of Therapy for Patients with Bronchiectasis"
Video 7 - "Harnessing Continuous Glucose Monitors for Type 1 Diabetes Management + Closing Words"
dr monica li
dr lawrence eichenfield
Dr Kevin Mallow, PharmD, BCPS, BC-ADM, CDCES
Video 14 - "Achieving Equitable Representation in Clinical Studies"
Related Content
© 2024 MJH Life Sciences
AJMC®
All rights reserved.