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Orphan drug costs and utilization are a double-threat to sustainability for small and mid-market health plans. Orphan drug expenditures take an increasingly large bite out of budgets which have a lower price sensitivity threshold than the largest plans. In addition, small and mid-market plans may be forced into more highly restrictive benefit and prior authorization policies, and higher member cost-sharing – all of which make them less competitive in the health plan market.

MRIoA helps health plans gain control of orphan drug costs and improve outcomes by ensuring access for patients truly in need while minimizing inappropriate utilization.