Clozapine Access Still Limited Despite REMS Removal, Expert Says
Although removing the REMS program reduced administrative burden, clozapine remains underprescribed. Reimbursement policies do not account for the extra monitoring and care the medication requires, according to Jose Rubio, MD, PhD. This mismatch continues to restrict access for eligible individuals.
The removal of the clozapine REMS program eased certain administrative steps, yet the medication is still prescribed less often than appropriate. According to Jose Rubio, MD, PhD, the problem now extends beyond paperwork.
Reimbursement rules reportedly fail to reflect the additional monitoring and clinical attention clozapine requires. Because payment does not match that care burden, access for patients who might be eligible may remain constrained even after the regulatory change.
People who might benefit from clozapine could face continued barriers if reimbursement does not cover monitoring and care. Clinicians may be less able or willing to prescribe it when payment structures don’t match workload. This may widen gaps in mental health treatment, though the exact societal effect depends on how payers and providers respond.