Fig. 1.

Methodology for drug market access determination. ^aUnknown and step therapy (ST Unknown) Status: Primarily for smaller regional plans (70% of unknown lives are from plans with < 300,000 lives). Managed Medicaid plans are most prominent among these unknown statuses, followed by commercial PPO plans. Typically, these types of smaller regional plans do not publicly publish detailed medical policies. ^bPrior Authorization (PA Unknown) Status: Plans where a PA is specified on their formulary; however, the details of the PA are not available and therefore cannot be assessed. PA restrictions are in place, but the details of those restrictions are unknown. PPO, preferred provider organization