In their new article published in the March issue of Health Affairs, Geoffrey Joyce of the University of Southern California and coauthors examine trends in the prevalence of utilization restrictions on non-protected-class compounds in Medicare Part D between 2011–20.
Utilization restrictions refer to policies like prior authorization or step therapy and formulary exclusions.
The researchers find that during the study period, “formulary exclusions and prior authorization or step therapy restrictions affected an increasing share of compounds…”
In 2011, 31.9 percent of compounds were restricted by Part D plans, compared to 44.4 percent in 2020.
Among other findings, Joyce and coauthors find an increasing reliance on formulary restrictions.
