Full coverage, partial coverage, no coverage for growth hormone treatment: Madison insurance choices as a microcosm

N. Fost, L. Fleming, D. Brock, M. Kaufman, M. MacGillivray, D. Sandberg, J. Fox, Ronald (Ron) Rosenfeld, T. Lipman, M. Pauly, D. B. Allen

Research output: Contribution to journalArticle

Abstract

HMOs differ in their policies on reimbursement for growth hormone prescriptions. Even with one city, policies range from full reimbursement, to 50% co-pay, to no reimbursement. Presently, decisions are made on a case by case basis, relying on a wide range of criteria. These include FDA approval for the indication, opinions by clinical experts, literature review of likely benefit, definition of disease, cost, availability of alternatives, concerns about adverse selection, whether employers are willing to purchase coverage, whether the treatment is investigational, and whether it is a "medical necessity" - although the definition of that term is unclear.

Original languageEnglish (US)
JournalEndocrinologist
Volume11
Issue number4 SUPPL.
StatePublished - 2001
Externally publishedYes

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Insurance
Growth Hormone
Investigational Therapies
Cost of Illness
Health Maintenance Organizations
Expert Testimony
Prescriptions
Therapeutics

ASJC Scopus subject areas

  • Endocrinology

Cite this

Fost, N., Fleming, L., Brock, D., Kaufman, M., MacGillivray, M., Sandberg, D., ... Allen, D. B. (2001). Full coverage, partial coverage, no coverage for growth hormone treatment: Madison insurance choices as a microcosm. Endocrinologist, 11(4 SUPPL.).

Full coverage, partial coverage, no coverage for growth hormone treatment : Madison insurance choices as a microcosm. / Fost, N.; Fleming, L.; Brock, D.; Kaufman, M.; MacGillivray, M.; Sandberg, D.; Fox, J.; Rosenfeld, Ronald (Ron); Lipman, T.; Pauly, M.; Allen, D. B.

In: Endocrinologist, Vol. 11, No. 4 SUPPL., 2001.

Research output: Contribution to journalArticle

Fost, N, Fleming, L, Brock, D, Kaufman, M, MacGillivray, M, Sandberg, D, Fox, J, Rosenfeld, RR, Lipman, T, Pauly, M & Allen, DB 2001, 'Full coverage, partial coverage, no coverage for growth hormone treatment: Madison insurance choices as a microcosm', Endocrinologist, vol. 11, no. 4 SUPPL..
Fost N, Fleming L, Brock D, Kaufman M, MacGillivray M, Sandberg D et al. Full coverage, partial coverage, no coverage for growth hormone treatment: Madison insurance choices as a microcosm. Endocrinologist. 2001;11(4 SUPPL.).
Fost, N. ; Fleming, L. ; Brock, D. ; Kaufman, M. ; MacGillivray, M. ; Sandberg, D. ; Fox, J. ; Rosenfeld, Ronald (Ron) ; Lipman, T. ; Pauly, M. ; Allen, D. B. / Full coverage, partial coverage, no coverage for growth hormone treatment : Madison insurance choices as a microcosm. In: Endocrinologist. 2001 ; Vol. 11, No. 4 SUPPL.
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