AMCP Market Insights: Payer best practices in food allergy management.

Abstract

The use of biologics in food allergy management is an emerging area; therefore, guidance is required for payers to ensure appropriate access. AMCP Market Insights undertook a multiphase program to refine proposed actions from a previous program into a set of payer best practices in food allergy management and to gain insights on gaps in knowledge regarding food allergy mechanisms and management. The program included a national survey of managed care professionals, individual expert interviews, and a moderated expert roundtable. Best practices identified were to increase awareness of food allergy mechanisms, mitigate accidental exposure impact, support behavioral health needs, ensure access to emergency medications, consider social determinants of health and equity, and assess cost-effectiveness. Best practices specific to omalizumab, which is currently the only biologic approved by the US Food and Drug Administration, were to establish appropriate initial coverage criteria and develop appropriate ongoing coverage criteria.