Utilization management criteria influence patients’ access to specialty drugs, yet the processes used by health plans to establish these criteria are not well understood. This study examined the ...

Assessing differences in utilization management between managing an IV product in terms of medical benefit vs. self-administered oral product in terms of pharmacy benefit. Transcript: Neil B. Minkoff, ...

We appreciate the thoughtful response of Susan Cantrell and the Academy of Managed Care Pharmacy to our work (August 2021). Our study highlights the burden of drug utilization management on the ...

Peter L. Salgo, MD: Stepwise, let’s come back. That goes back to what I was asking you. We can all dive in on this. How do you recognize who gets them? In other words, you said “stepwise.” They’ll try ...

Utilization management policy has many forms, but has become increasingly complex as cancer scientific discovery has blossomed, cancer subtypes have become more numerous, therapeutic opportunities ...

Utilization management involves methods by health care plan administrators to minimize costs while also maintaining the quality of care. The process is intended to prevent wasteful spending but not to ...

The Health Insurance Review and Assessment Service (HIRA) announced on July 9 that it will fully implement a "full-cycle management system for non-rei ...