U.S. health plan coverage of Neuromuscular Disease Therapies: An assessment of policy availability and restrictions

Many plans lacked publicly accessible policies, and most covered therapies were subject to restrictive requirements. These barriers-such as step therapy, narrow prescriber criteria, and short approval periods-may delay treatment and disrupt care continuity. Findings underscore the need for greater transparency and reform in prior authorization and pharmacy benefit design to support timely access to NMD therapies.

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Publication Details

Journal
Journal of Neuromuscular Diseases
Published
2025-12-09
DOI
https://doi.org/10.1177/22143602251405815
Primary Topic
Myasthenia Gravis and Thymoma
Type
article
Field-Weighted Citation Impact
0.00
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article

U.S. health plan coverage of Neuromuscular Disease Therapies: An assessment of policy availability and restrictions

Julia A Rucker, A. Alex Levine, James D. Chambers, Alex R Cockerham et al.
Journal of Neuromuscular Diseases
Myasthenia Gravis and Thymoma
article

U.S. health plan coverage of Neuromuscular Disease Therapies: An assessment of policy availability and restrictions

Julia A Rucker, A. Alex Levine, James D. Chambers, Alex R Cockerham, Joel Cartner
article en

Abstract

Many plans lacked publicly accessible policies, and most covered therapies were subject to restrictive requirements. These barriers-such as step therapy, narrow prescriber criteria, and short approval periods-may delay treatment and disrupt care continuity. Findings underscore the need for greater transparency and reform in prior authorization and pharmacy benefit design to support timely access to NMD therapies.

Journal of Neuromuscular Diseases
Tufts Medical Center (US), Sarepta Therapeutics (United States) (US)
Openalex Percentile: Top 46%
Myasthenia Gravis and Thymoma
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