ICER Fair Access Report Gives Payers High Marks
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Dec 24, 2024
Most major commercial payers provided fair access to a sample of prescription medications, according to a recent review from the Institute for Clinical and Economic Review (ICER). Sarah Emond, ICERâs president and CEO, tells AIS Health that payers âshould be given a lot of credit for being in line with a lot of the criteria that weâve established.â However, she cautions it is difficult to assess how payers implement the written policies in a real-world setting.
ICERâs fourth annual âBarriers to Fair Accessâ report, published on Dec. 19, assessed coverage policies associated with 11 medications that the nonprofit organization evaluated for cost-effectiveness in 2022. The authors identified the 10 largest commercial payers in the U.S. and selected those insurersâ largest formularies based on the number of covered lives. They obtained the formulary data from MMIT, AIS Healthâs parent company, which also provided information on coverage policies if the payer did not share them with ICER.
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