Opinion|Videos|May 2, 2025

Payer-Related Barriers With Therapies Used for Uncomplicated UTIs

Panelists discuss how recurrent urinary tract infections (UTIs) treated with older antibiotics generate 2 to 3 times higher total costs than initial savings, warranting cost-effectiveness analyses in treatment decisions, whereas payers create barriers to newer therapies through restrictive authorizations, high co-pays, step therapy mandates, and limited formulary inclusion that providers can navigate via detailed documentation, pharmacy benefit manager engagement, patient assistance programs, and advocacy for evidence-based coverage policies.

Video content above is prompted by the following:

  • To what extent does the economic burden of recurrence in patients treated with older, more affordable drugs offset the initial cost savings, and how should this affect treatment decisions?
  • What payer-related barriers might arise for these emerging treatments for patients who have experienced treatment failure with traditional therapies?
  • How can health care providers advocate for their patients in these situations?

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