If a patient’s condition is stabilized on their current therapy then they have a right to stay on the medicine their doctor has prescribed. This right should persist from plan year to plan year, and continue even if the health plan drops the medicine from its formulary. Only with the patient’s and doctor’s consent should a health plan or a pharmacy be able to switch a patient to a different therapy.
Content created by Keep My Rx.
How insurers' prior authorization requirements burden physicians and blocks heart patients' access to medicine.
Read MoreBy addressing specialty tiers, policymakers and insurers can help more patients access the treatment their physician prescribed.
Read MoreInnovation comes at a price, one that health insurers may hesitate to pay. While some patients reap a benefit from breakthrough drugs, others do not. So how can insurers reduce their financial risk and give patients access to the innovative prescription drugs their doctor prescribes? A new video from the Alliance for Patient Access explores one intriguing option: value-based contracting.
Read MoreClinical pathways streamline care by steering patients toward predetermined treatment options in a predetermined order. Insurance companies encourage their use with high-cost conditions, particularly cancer.
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