Specialty Drug Reimbursements Vary Widely, Study Shows

July 12, 2018

Only 16 percent of coverage policies are consistent across the largest U.S. commercial health plans for specialty drugs, according to July 2018 study in Health Affairs.

For the study, researchers analyzed 3,417 specialty drug coverage decisions issued by the largest U.S. commercial health plans. They looked for variation in coverage and consistency with indications approved by the U.S. Food and Drug Administration (FDA).

They found that only 16 percent of the 302 drug-indication pairs were covered the same way by all of the health plans.

Other highlights of the study include:


View the study.