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S4, Ep 8- Beyond the Formulary: Uncovering the Hidden Impact of Drug Exclusions

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Dr. Robert Popovian and Conner Mertens, along with guest Catherine Hicks, a patient diagnosed with juvenile idiopathic arthritis as a child, dive into the complex world of formulary exclusions. They discuss how these exclusions impact patient care and the hidden consequences they bring, including how Catherine was personally impacted. Dr. Popovian also shares learnings from GHLF’s research work, shedding light on the clinical and economic implications of these exclusions. Tune in for a deep dive into the realities of navigating health care policy and the pressing need for patient advocacy.

Among the highlights in this episode:

01:50: Conner asks Dr. Popovian to explain formulary exclusions

02:30: Our guest, Catherine Hicks, shares her struggle with juvenile idiopathic arthritis and epilepsy, detailing how formulary exclusions led to severe health complications and long-term spinal damage 

03:50: Catherine emphasizes the human impact of formulary exclusion decisions, highlighting how these affect not just individuals but large groups of patients

05:48: Dr. Popovian describes the research conducted by GHLF, revealing that a significant percentage of drug exclusions are neither clinically nor economically beneficial

09:06: Catherine stresses the importance of patient self-advocacy in navigating health care and insurance systems, based on her personal experiences 

10:55: Conner asks Dr. Popovian about alternatives to formulary exclusions and how to combat their negative effects

11:12: Dr. Popovian discusses the lack of active legislation addressing formulary exclusions and the need for collective policy efforts to prohibit such practices

12:42: Conner summarizes the episode, highlighting the harm caused by formulary exclusions to patients like Catherine 

13:12: Dr. Popovian shares some final thoughts

You can watch the "Impact of Formulary Exclusions on Individual Patients" webinar at: 

You can access both Analysis of Formulary Exclusions papers via the links below:

Analysis of Drug Formulary Exclusions from the Patient's Perspective: 2023 Update 

Modeling the Effects of Formulary Exclusions: How Many Patients Could Be Affected by a Specific Exclusion? 

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF:

Conner Mertens, Patient Advocate and Community Outreach Manager at GHLF:

A podcast series produced by Ben Blanc, Manager of Programs & Special Projects at GHLF.

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