I have been following the progress of contraceptive insurance coverage in USA since the state of Vermont passed legislation to enforce compliance. As of last week the Biden administration has issued additional compliance actions. If you are up for the read this is the link https://www.cms.gov/files/document/faqs-part-64.pdf
This is what caught my attention from the article:
Q2: How will the Departments determine whether a contraceptive drug or drug-led deviceis therapeutically equivalent to another drug or drug-led device?
The Departments will consider a contraceptive drug or drug-led device to be therapeuticallyequivalent to another drug or drug-led device if the drug products or drug-led devices areidentified as therapeutic equivalents (that is, designated with a code with the first letter “A”) inthe FDA’s Approved Drug Products with Therapeutic Equivalence Evaluations (Orange Book).26The Departments will consider a drug or drug-led device for which the Orange Book has notidentified any therapeutic equivalents to have no therapeutic equivalent. For example, as of thedate of publication of these FAQs, under the category of “intrauterine devices with progestin (alldurations and doses),” there are four FDA-approved products available; however, none of thefour products are listed in the Orange Book as therapeutic equivalents to each other, so theDepartments would treat each of these products as having no therapeutic equivalent.
The implications for MYX are huge for both Nexstellis and Annovera which have no therapeutic equivalent and must therefore be 100% covered by insurance at no cost to the patient.
Cheers
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I have been following the progress of contraceptive insurance...
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