1. Pink Sheet
  2. >>Market Access

Step Therapy: As Bill Aims To Routinize Processes, Study Finds Policies Often Stricter Than Clinical Guidelines

 
• By Cathy Kelly

Chronic migraine and anti-inflammatory treatments were most often subject to step therapy, Tufts researchers found. Policies varied from payer to payer, raising concerns over the impact of shifting requirements for treating the same disease as patients move among insurers.

Lots Of Steps To Climb • Source: Alamy

Step therapy policies for specialty drugs among large commercial insurers in the US were more stringent than corresponding clinical guidelines about half of the time in a new study funded by Genentech, Inc. and conducted by researchers at the company and the Center for Evaluation of Value and Risk in Health at Tufts Medical Center.

Published in the November issue of Health Affairs, the study by Lenahan et al. looked at the step therapy policies...

Read the full article – start your free trial today!

Join thousands of industry professionals who rely on Pink Sheet for daily insights

  • Start your 7-day free trial
  • Explore trusted news, analysis, and insights
  • Access comprehensive global coverage
  • Enjoy instant access – no credit card required
Start Free Trial

Already a subscriber?

More from Market Access

Oz Says Big PBMs Have ‘Window’ to Quit Rebate System on Their Own

 
• By Leslie Small

CMS Administrator Mehmet Oz said PBMs may deserve "one last chance" to fix the rebate system before federal regulations and legislation are enacted.

Denmark Introduces First Confidential Pricing Framework For Primary Care Medicines

 
• By Francesca Bruce

Expanded confidential pricing for pharmaceuticals is intended to help manage medicines expenditure, according to Amgros, the procurement agency that will negotiate the prices.

Canada Unveils Draft List of Essential Drugs For Universal Pharmacare

 
• By Neena Brizmohun

The list of essential prescription drugs and related products will shape Canada’s first national formulary for the country’s universal pharmacare program.

Repurposed Drugs: EU Pharma Reform Offers Boost, But Payers ‘Must Recognize Health Gains’

 
• By Eliza Slawther

Incentives for repurposed drugs proposed as part of the EU pharma reform package are a “great step forward,” but more recognition is needed from payers and regulators to leverage the benefits of these medicines, experts say.

More from Pink Sheet

Canada Unveils Draft List of Essential Drugs For Universal Pharmacare

 
• By Neena Brizmohun

The list of essential prescription drugs and related products will shape Canada’s first national formulary for the country’s universal pharmacare program.

Repurposed Drugs: EU Pharma Reform Offers Boost, But Payers ‘Must Recognize Health Gains’

 
• By Eliza Slawther

Incentives for repurposed drugs proposed as part of the EU pharma reform package are a “great step forward,” but more recognition is needed from payers and regulators to leverage the benefits of these medicines, experts say.

Post-BIO Podcast: Thoughts From The Frontlines

 
• By Sarah Karlin-Smith, Mandy Jackson, and Mary Jo Laffler

Pink Sheet and Scrip journalists reflect on the mood from Boston, the most important takeaways and what’s next for industry.