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Medicaid formularies for rosacea treatment are often restrictive and show inconsistency in transparency and coverage.
J Am Acad Dermatol
January 2025
Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts. Electronic address:
Disparities in Use of Novel Diabetes Medications by Insurance: A Nationally Representative Cohort Study.
J Gen Intern Med
November 2024
Division of Hospital Medicine, San Francisco General Hospital, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Background: Minority racial and ethnic populations have the highest prevalence of type 2 diabetes mellitus but lower use of sodium-glucose co-transporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP1ra), novel medications that reduce morbidity and mortality. Observed disparities may be due to differences in insurance coverage, which have variable cost-sharing, prior authorization, and formulary restrictions that influence medication access.
Objective: To assess whether racial/ethnic differences in SGLT2i and GLP1ra use differ by payer.
Health care decision-maker perceptions and trends in the utilization of preapproval information for formulary decision-making.
J Manag Care Spec Pharm
May 2024
Cencora, Conshohocken, PA.
Article Synopsis
- Preapproval information exchange (PIE) between biopharma companies and healthcare decision-makers (HCDMs) has improved, but there's still a mismatch between HCDM needs and the information provided by biopharma.
- *The study surveyed 17 HCDM advisors to understand the use of preapproval information and its effectiveness for formulary decisions, finding that nearly half believe it speeds up the decision-making process.
- *Key resources that support PIE include AMCP preapproval dossiers, webinars, and presentations, with most respondents highlighting the value of timely clinical and economic data for evaluating budget impacts.
A Comparison of Currently Approved Small Interfering RNA (siRNA) Medications to Alternative Treatments by Costs, Indications, and Medicaid Coverage.
Pharmacy (Basel)
March 2024
College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, Tallahassee, FL 32307, USA.
Small interfering RNA (siRNA)-based medications offer the ability to target previously undruggable targets and have now received FDA approval in five instances for orphan or uncommon diseases. The current siRNA "-sirans" are directed towards hepatic molecular targets. Because they are not conventional drug formulae, their ultimate clinical success will require overcoming multiple barriers beyond their pharmacology.
View Article and Find Full Text PDFSubstance use disorder treatment carve outs in Medicaid managed care.
J Subst Use Addict Treat
June 2024
Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, United States of America.
Introduction: Medicaid managed care organizations (MCO) play a major role in addressing the nation's epidemic of drug overdose and mortality by administering substance use disorder (SUD) treatment benefits for over 50 million Americans. While it is known that some Medicaid MCO plans delegate responsibility for managing SUD treatment benefits to an outside "carve out" entity, the extent and structure of such carve out arrangements are unknown. This is an important gap in knowledge, given that carve outs have been linked to reductions in rates of SUD treatment receipt in several studies.
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