Formulary-Related Insurance Denials of Single-Source Branded Drugs in the United States
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The authors aimed to estimate the frequency of formulary-related rejections and the subsequent dispensing of single-source branded drug prescriptions in the United States. They found that 32% of initial fill attempts were rejected, primarily due to formulary exclusions or utilization management, leading to significant delays in treatment initiation and often resulting in no medication being filled within the same therapeutic class. This study highlights the increasing trade-offs between cost containment and access to necessary medications.
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