ArticleJournal of managed care & specialty pharmacy2025
Use of health technology assessments in specialty drug coverage decisions by US commercial health plans.
Article in Journal of managed care & specialty pharmacy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed.
- Ethical Considerations in Health Technology Assessment for Precision Medicine: A Delphi Study in a Greek Setting.Journal of personalized medicine · 2026Article
- Use of clinical outcome assessments in specialty drug coverage policies.Journal of managed care & specialty pharmacy · 2026Article
- Access in all areas? A round up of developments in market access and health technology assessment: part 7.Journal of comparative effectiveness research · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHealth technology assessment (HTA) involves a formal review of the clinical, economic, and societal implications of health technologies. Internationally, HTA supports decisions regarding access to novel therapeutics. However, the role of HTA in the decision-making processes of US-based health care payers remains unclear.
objectiveTo assess how frequently US commercial health plans reference HTAs in their specialty drug coverage policies.
methodsUsing the Tufts Medical Center Specialty Drug Evidence and Coverage database, we reviewed the evidence cited in the publicly available specialty drug coverage policies of 17 US commercial health plans. We assessed the frequency of HTA citations and characterized them by (1) country of origin, (2) publishing organization, (3) whether it addressed a treatment's cost-effectiveness, (4) disease category addressed, and (5) whether it assessed orphan or nonorphan treatments.
resultsHTAs accounted for 450 of the 14,033 citations in our analysis (3.2%), with the frequency of HTA citations varying across health plans (0.1% to 7.4% of cited evidence). Ex-US HTAs were cited more frequently than US-based HTAs (65.3%). However, a single health plan accounted for the majority of HTA citations (57.1%) and ex-US citations (76.2%). Most cited HTAs included cost-effectiveness assessments (78.7%). The 3 disease categories for which plans most often cited HTAs were neurological disorders (24.8%), musculoskeletal disorders (21.5%), and cancers (14.6%). Health plans cited HTAs for nonorphan drugs more often than for orphan drugs (59.4%).
conclusionsHTAs represented a small portion of the evidence cited by health plans in specialty drug coverage decisions, with significant variation in citation frequency across plans. Plans cited both US and ex-US HTAs, and most cited HTAs included a cost-effectiveness assessment. These findings suggest that health plans may consider the information provided by HTAs when formulating coverage policies.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.