Article type
Abstract
Background: Cochrane systematic reviews (CSR) are used to develop evidence-based medical policies of the various private healthcare payers. In United States (US), private payers are one of the key stakeholders in healthcare decision making. Payers' drug policy documents are used to inform whether a health technology is proven to be effective based on the published clinical evidence and is a medical necessity.
Objectives: Aim of the study was to assess the use of CSR to inform the drug policy documents of major private US healthcare payers.
Methods: The publically available drug policy documents of the five major US private payers (Aetna, Cigna, UnitedHealth care [UHC], Anthem, and Humana) were reviewed to find CSR used, by hand-searching. Data such as: use of CSR, number of CSR used, context of use of CSR, impact of CSR on policy, Cochrane Review Group (CRG) and center to which CSR belongs, were extracted on an excel sheet. Data pertaining to number of CSR produced was accessed from Archie.
Results: Among the selected payers, 13% of the policy documents have used CSR, maximum for Aetna (52%) and minimum for Humana (2%). 361 Cochrane reviews from 42 CRG have been used to inform 118 drug policy documents. Maximum number of CSR used from any one Cochrane centre was 79 (UK). Maximum reviews used from any one CRG was 27 (Musculoskeletal Group). The most frequently used review across the payers was CD007848 (7 policies). Maximum CSR used to inform any one policy was 18 (Drug: Botulinum Toxin, Payer: Atena). Overall 66% of the CSR were used to inform background of the document and 34% supported the clinical usage of the drug, furthermore 42% of the CSR imparted high impact on the policies they were used to inform.
Conclusions: The US healthcare payers’ policies are informed by CSR, however, vast scope exists to encourage further usage of CSR. The main purpose of Cochrane is to enable healthcare stakeholder to make best possible decisions about healthcare, initiatives to increase knowledge translation by communicating evidence to healthcare stakeholders can be adopted to increase the use of Cochrane evidence to inform the healthcare policy across the globe.
Objectives: Aim of the study was to assess the use of CSR to inform the drug policy documents of major private US healthcare payers.
Methods: The publically available drug policy documents of the five major US private payers (Aetna, Cigna, UnitedHealth care [UHC], Anthem, and Humana) were reviewed to find CSR used, by hand-searching. Data such as: use of CSR, number of CSR used, context of use of CSR, impact of CSR on policy, Cochrane Review Group (CRG) and center to which CSR belongs, were extracted on an excel sheet. Data pertaining to number of CSR produced was accessed from Archie.
Results: Among the selected payers, 13% of the policy documents have used CSR, maximum for Aetna (52%) and minimum for Humana (2%). 361 Cochrane reviews from 42 CRG have been used to inform 118 drug policy documents. Maximum number of CSR used from any one Cochrane centre was 79 (UK). Maximum reviews used from any one CRG was 27 (Musculoskeletal Group). The most frequently used review across the payers was CD007848 (7 policies). Maximum CSR used to inform any one policy was 18 (Drug: Botulinum Toxin, Payer: Atena). Overall 66% of the CSR were used to inform background of the document and 34% supported the clinical usage of the drug, furthermore 42% of the CSR imparted high impact on the policies they were used to inform.
Conclusions: The US healthcare payers’ policies are informed by CSR, however, vast scope exists to encourage further usage of CSR. The main purpose of Cochrane is to enable healthcare stakeholder to make best possible decisions about healthcare, initiatives to increase knowledge translation by communicating evidence to healthcare stakeholders can be adopted to increase the use of Cochrane evidence to inform the healthcare policy across the globe.