In Financial Times Health Payer Specialist, Margaux Hall Examines Drug Coverage Decision Criteria

As the price of specialty prescription drugs rise, health payers are tuning their strategies for providing drug coverage for their members. 

In a Financial Times Health Payer Specialty article, health care partner Margaux Hall (Washington, D.C.) examines the drug coverage criteria often used by health care payers. Margaux explains that in deciding whether to cover a drug, most payers rely on pharmacy and therapeutic committees that study pharmacoeconomics and how effective and convenient particular drugs are. She notes that many payers must abide by legal requirements when making drug-coverage decisions.