Drug
Inclusions and Exclusions
Drug inclusions and exclusions, with roots in traditional indemnity
insurance, strive to curb medically unnecessary utilization.
Table 40 shows the drug treatments and therapeutic classes that
employers commonly exclude from coverage.
While many employers exclude certain treatments and classes, others
may cover them with no exclusion or controls for managing utilization.
Table 41 illustrates the range of management tools employers are
using for these often costly drugs.
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