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Research Paper | Pharmacy | United States of America | Volume 13 Issue 6, June 2024 | Rating: 4.6 / 10

Dissecting the Temporal Impact of U.S. Managed Care Decisions on Newly Launched Drugs and Therapies

Dinesh Kabaleeswaran ^[6] | Dhruv Patel ^[5]

Abstract: The global disease burden patients are increasingly experiencing spans many different conditions, including oncology, non-oncology, immunology, and rare diseases. In a complex healthcare ecosystem, ensuring patients have reliable and timely access to vital medications to address these conditions is a top priority. In the United States, new drugs and therapies are approved year over year, prompting various market entities to employ diverse mechanisms to regulate the accessibility of these novel agents. Among the strategies managed care organizations use to control access to medications, such as prior authorizations and step therapy restrictions, a management approach known as new drug launch policies has emerged over the last decade and has continued to evolve. Pharmacy and therapeutics committee members may not immediately authorize newly launched medications for patient access, as managed care stakeholders require time to project the potential impact on their internal budgets. This research explores the time taken by decision makers in the world of managed care to establish final coverage and reimbursement policies for newly launched drugs and therapies in the United States, and also investigates potential variations in this process for life-saving oncology treatments compared to other critical indications.

Keywords: managed care, pharmacy benefit, medical benefit, oncology, non-oncology

Edition: Volume 13 Issue 6, June 2024,

Pages: 647 - 651