ICER will will conduct our third annual assessment of how well major insurers’ prescription drug coverage policies align with a set of fair access standards developed by ICER with expert input from patient advocates, clinician specialty societies, US payers, pharmacy benefit managers, and life science companies. For each of the drugs reviewed by ICER in 2021 we will perform analyses of the proportion of selected fair access criteria that are met in these formularies, analyzed across drugs, conditions, and payers. 

ICER will use the MMIT’s market access Analytics solution to identify the formularies that will be included, and will solicit coverage policies directly from payers, supplementing their responses with information from the MMIT database. For this report, ICER will review multiple formularies offered by the five largest US commercial payers, state health exchange plans in the four geographic regions of the US, and the Department of Veterans Affairs.

For questions or additional information, please contact Meaghan Cummings, Special Assistant to the President, at mcummings@icer.org.