Avalere’s new study on nationwide formulary coverage and cost-sharing among Silver Qualified Health Plans (QHPs) shows:
- Overall QHP drug coverage improved across most disease areas; however, it varies by state and lags behind employer coverage in many cases.
- Silver QHPs place meds to treat multiple sclerosis on specialty tiers 50% as often as employer plans and meds to treat cystic fibrosis 44% as often.
- Up to 15% of all Silver QHPs impose 40% co-insurance rates for all covered drugs in certain classes used to treat cancer.
- In 2016, 12% more plans required greater than 40% co-insurance for antidepressant drugs than in 2015.
- 35% of Silver QHPs use prior authorization and step-therapy.
Read more here.
Last Updated on May 12, 2020 by Aimed Alliance
