The following infographics highlight how health plans leverage PAs in trending therapeutic areas. Payers implement prior authorizations to control costs and restrict reimbursement for specific drugs. A clinical review of these utilization management strategies reveals that some plans often require PAs that are restrictive to the drug's FDA approved label.
Multiple Sclerosis: Over half of the largest payers that cover MS treatments implement PA policies. Click on the image to view more.
Cystic Fibrosis: A review of pharmacy benefit structures for CF treatments reveals that roughly 20% of lives require a prior authorization that is restrictive to the FDA approved label. Click on the image to view more.
Detoxification Agents: For alcohol deterrence products, roughly 1/3 of PAs are restrictive-to-label when present. Click on the image to view more.
Antidepressants: Utilization management from top payers shows that PAs for roughly 44% of lives are restrictive to their label. Click on the image to view more.
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