By: Wayne Turner
Executive Summary
Under federal rules, health plans subject to the Essential Health Benefits must cover a minimum of one drug per U.S. Pharmacopeia (USP) class and category. However, the USP classification system used for EHB was designed for Medicare Part D, and falls short on covering pediatric formulations, drugs used for reproductive health, as well as plasma-derived and recombinant products. In these comments to the USP, NHeLP highlights some areas for improving a new USP Drug Classification system, the USP/DC, which will likely set the standard for EHB drug coverage in the future.