Health Affairs March 1, 2024
Geoffrey Joyce, Barbara Blaylock, Jiafan Chen, Karen Van Nuys

Abstract

Drug utilization management tools can be employed to ensure that medicines are prescribed cost-effectively, but they can also be implemented in ways that reduce adherence and harm patient health. We examined trends in the prevalence of utilization restrictions on non-protected-class compounds in Medicare Part D plans during the period 2011–20, including prior authorization and step therapy requirements as well as formulary exclusions. Part D plans became significantly...

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Topics: Insurance, Medicare, Medicare Advantage, Patient / Consumer, Provider
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