Formulary coverage for lipid-lowering drugs recommended for children.
OBJECTIVE
A cross-sectional assessment to describe availability, coverage, and pediatric labeling status of lipid-lowering drugs offered by 1 private and 1 public insurance plan formularies.


RESULTS
Both insurance plans had equal medication availability of bile acid sequestrants (7), statins (10), and cholesterol-absorption blockers (CAB; 1). The private plan had 3 bile acid sequestrants and 3 statins listed as preferred drugs; the CAB was not preferred. In contrast, the public plan had 5 bile acid sequestrants, 7 statins, and the CAB as preferred drugs. For medications with pediatric labeling, the private plan covered 50% as preferred drugs whereas the public plan covered 70% as preferred drugs.


CONCLUSIONS
If new recommendations of the American Academy of Pediatrics for treatment of dyslipidemia in children were implemented today, children with the public plan would have equal choice but better coverage of lipid-lowering drugs as preferred drugs, including those with FDA approval, compared with children with the private plan.
Yoon
Esther Y
EY
Division of General Pediatrics, University of Michigan, Ann Arbor, Michigan, USA. est@med.umich.edu
Freed
Gary L
GL
Davis
Matthew M
MM
Clark
Sarah J
SJ
D000293:Adolescent; D000328:Adult; D000924:Anticholesteremic Agents / Q000191:economics* / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination; D050171:Dyslipidemias / Q000188:drug therapy*; D005260:Female; D005569:Formularies as Topic; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D007223:Infant; D007231:Infant, Newborn; D019458:Insurance Coverage; D007356:Insurance, Pharmaceutical Services / Q000706:statistics & numerical data; D008297:Male; D008824:Michigan; D016896:Treatment Outcome; D014481:United States
D000924:Anticholesteremic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors