Question  Does Medicare Advantage step therapy change prescribing patterns for macular degeneration physician-administered drugs?

Findings  This retrospective encounter-based analysis including data from 171 985 macular degeneration drug administrations among a 20% nationally representative Medicare Advantage encounter sample revealed that from 2017 to 2019, step therapy was associated with a 7.8% greater probability of prescribing the plan-preferred drug for the first administration of a treatment episode. The predicted probability of being prescribed the plan-preferred drug for the treatment group increased from 0.61 before to 0.70 after the introduction of step therapy.

Meaning  These findings suggest that step therapy for macular degeneration drugs slightly increases the prescribing of insurer-preferred products.

JAMA Health Forum. 2024;5(8):e242446. doi:10.1001/jamahealthforum.2024.2446