What’s fair: ICER report finds insurer coverage typically meets access criteria for 18 prescription drugs

Drug pric­ing watch­dog ICER on Fri­day un­veiled its third an­nu­al score­card on how “fair­ly” sev­er­al US in­sur­ers and PBMs cov­ered 18 pre­scrip­tion drugs across 19 for­mu­la­ries in 2021, find­ing a “high de­gree of align­ment” be­tween in­sur­ance poli­cies and ICER’s fair ac­cess cri­te­ria.

“While the ev­i­dence avail­able and the lim­i­ta­tions of our re­search ef­fort leave many ques­tions, our re­sults demon­strate that the ma­jor­i­ty of pay­er poli­cies in the for­mu­la­ries eval­u­at­ed are struc­tured in a way to sup­port many key el­e­ments of fair ac­cess,” the group said in the re­port.

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