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Do large health insurers in the U.S. provide “fair access” to prescription medicines?

The answer to that question is nettlesome and elusive, at least according to a new analysis.


At first blush, it appears that 15 of the biggest commercial health insurers do, indeed, make medications available fairly based on a few key criteria: prescriber restrictions, eligibility based on clinical data, and step therapy, which requires patients to try other medicines before approving a prescription. But practices are spotty when it comes to cost-sharing, the portion of expenses paid by insured individuals.

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