Dosage and indication “creep” with the new biologics to treat inflammatory diseases have payers enforcing strict utilization policies. Physicians counter that payers can’t dictate treatment. With even more biologics on the horizon, and drug spend spiralling upward, both sides need to seek a middle ground. The question is how?
“It’s a bit like solving a Rubik’s Cube” when dealing with new immunomodulators, says Helen Sherman, PharmD, with RegenceRX. “We keep track of all the science and potential uses, but this is a complex category.”
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