What's Really Behind Discrepancies in Coverage Decisions?

Dan Leonard, NPC President

In his latest column for Specialty Pharmacy Times, National Pharmaceutical Council President and CEO Dan Leonard looks at what’s really behind the discrepancies in coverage decisions from one insurer to the next. Mr. Leonard discusses research that uncovers the reasons for these health coverage policy decisions. “Some variation in the evidence that plans report reviewing is expected, but the extent of variation in the volume, composition and consistency of the cited evidence is notable and may be a key factor behind the inconsistent coverage that patients encounter,” Mr. Leonard writes. “These coverage decisions should be based on a complete review of the comprehensive set of evidence using accepted methods to assess the quality and certainty of evidence.

Read about his recommendations for solutions to this problem on the Specialty Pharmacy Times website.