Who Decides? How Pharmacy and Therapeutics Committees Impact Patient Access
Pharmacy and therapeutics committees decide which medications will be used or covered by hospital systems, state Medicaid programs, insurers and federal agencies. These committees consist of clinicians, pharmacists and nurses but also administrators, quality-improvement managers and other health care professionals. Their decisions have a direct impact on patients’ treatment options and access to medication. Read […]
Who Decides? How Prescription Drug Affordability Boards Impact Patient Access
Individual states sometimes establish prescription drug affordability review boards to explore ways to lower prescription medication costs for Medicaid patients and reduce the impact on the state health care budget. State legislators pass laws to create prescription drug affordability review boards. Read More
Who Decides? Pharmacy Benefit Managers & Medication Access
Patients who rely on prescription medication may encounter bureaucratic delays, high out-of-pocket costs or forced medication switching. These hurdles often stem from the work of middlemen known as pharmacy benefit managers. Read More
Who Decides? How ICER Impacts Patient Access
The Institute for Clinical and Economic Review is a health economics organization that assesses the value of new drugs, medical devices and diagnostics. Though ICER is not a government entity, its decisions often impact medication coverage by public and private health plans. Nevertheless, patients, clinicians and caregivers lack meaningful opportunities to provide input on ICER’s […]
Who Decides? Defining the Value of Medical Treatment
What is the value of a new medication or medical device? The question is complex, and answers often vary depending upon who decides and which factors they prioritize. Nevertheless, decisions about value regularly determine which treatments are accessible and which patients can benefit from them. Read More
