Medical & Rx Policy Criteria
Clinical criteria & policy details by medical & pharmacy determination
Analyze the policy details behind standard formulary placement impacting coverage and reimbursement of your most valued products in your portfolio.
Identify the detailed breakouts of medical benefit, pharmacy benefit, and dual benefit patients for your market baskets.
Access drug policy documents with detailed coverage language.
Restrictions details can be filtered by geography, insurance segment, and narrowed down to PBM, Parents, or Payers.
Features
Daily Alerts
Receive detailed daily alert emails sent directly into your inbox informing any formulary or policy changes from the previous day for your subscribed drugs and payers.
Downloadable Source Files
All restrictions criteria statuses are supported by source policy documents that can be downloaded directly to your computer.
Nomenclature based on Policy Details
We research every drug to each brand’s specific business rules for each indication.
Customer Benefits
A comprehensive Medical Benefit report suite enables users to stay ahead of policy changes for Medical vs Dual Benefit drug coverage. Users can view all in one place the various policy documents in place for entire therapeutic areas.
- Access to over 250,000 payer drug policies in our internal library
- Drug policy restrictions criteria reviewed daily
- Policy documents available with one click
Data Platform and Solutions
One comprehensive tool for all of your market access needs.
Get the most out of our Drug Coverage Analytics by pairing with all or some of our other solutions.
Drug Coverage Analytics
Gather formulary coverage information for your market baskets by geography, insurance segment, and payers. Always updated daily.
Drug Coverage Promotion
Quick and easy creation of sell sheets for prescriber targeting & pull-through messaging.
Medical & Rx Policy
Identify the detailed breakouts of medical benefit, pharmacy benefit, and dual benefit patients for your market baskets.
Drug Utilization
Integrate 3rd party utilization data with our formulary, lives, and policy information to create consolidated reports on our platform.