STATEMENT FROM BRIAN KENNEDY, EXECUTIVE DIRECTOR, ALLIANCE FOR PATIENT ACCESS:
Evaluating cost effectiveness of breakthrough therapies like TIMs for rheumatoid arthritis is an important exercise. But patients can be hurt when health plans use the results of predictive modeling, which are inherently imprecise, to justify restrictions on which medications they’ll cover for which patients.
Population-level analytics cannot predict which treatment will work for any individual patient. So these data points should not be used by health plans to override the physician-patient relationship and impede a physician’s ability to determine the best course of treatment for a given patient.