Cancer patient getting treatment (Photo: Shutterstock)

Access to specialty drugs through commercial health plans decreased from 2017 to 2021, and less than half of plans were consistent with FDA drug label indications, a recent study found. The National Pharmaceutical Council conducted the study in partnership with the Center for the Evaluation of Value and Risk in Health at Tufts Medical Center.

“Our study indicates that the use of these restrictions is on the rise,” said Rochelle R. Henderson, Ph.D., who led the study. “It is important for employers, benefit advisors and brokers to consider that these restrictions can hinder patient access to the treatments their clinicians prescribe and worsen their outcomes while increasing health system costs. Our study suggests that some payers might be doing the math and not appreciating the downsides of placing hurdles in front of patients.”

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