Health plan and pharmacy benefit manager decision making
Medically complex children account for 20% of medical services and 80% of children’s health costs (4). Health Plans and PBMs need evidence to support prior authorization, drug coverage and care management for the group. Citations in Resource Section.
An evidence-based neonatal and pediatric drug information resource will provide clinically relevant content to support payment, Pharmacy and Therapeutics Committee, and care management decisions for neonatal and pediatric therapy.