Key Takeaways. (1) Like most health plans, health insurance marketplace plans apply utilization management (UM)--tools to manage access to and the cost of certain prescription drugsāto balance drug spending and appropriate consumer access. (2) From 2016 to 2020, the percentage of covered brand name drugs by marketplace plans decreased and the percentage of covered brand name drugs with UM increased in several therapeutic areas. (3) These UM trends call for insurers, policy makers, and other stakeholders to consider new policies to help consumers navigate prescription drug coverage requirements.
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