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Little Consistency In Evidence Cited By Commercial Plans For Specialty Drug Coverage
James D Chambers1, Ari D Panzer2, Elle F Pope3
1James D. Chambers ( jchambers@tuftsmedicalcenter. org ) is an investigator in the Center for the Evaluation of Value and Risk in Health, Tufts Medical Center, and an associate professor of medicine in the School of Medicine, Tufts University, both in Boston, Massachusetts.
Abstract:
We found wide variation in the evidence that US commercial health plans reported reviewing in their specialty drug coverage policies. There was little consistency in the numbers or types of studies cited by health plans. On average, only 15 percent of health plans' coverage policies cited the same study evaluating a specific drug for a specific indication.
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