Evidence Synthesis
Evidence graded by iZO, aligned to payer criteria
Illustrative synthetic dataOptum RWD / Claims / HEORiZO Medical Affairs
Evidence library
9 of 11 selected · default selection matches National PBM Plan A
| Evidence | Origin | Barriers | Strength | ||
|---|---|---|---|---|---|
EV-01 · Pivotal RCT (illustrative) Renvora reduced a composite kidney outcome versus standard of care in adults with T2D and CKD. | iZO Medical Affairs | StepPA | High | ||
EV-02 · Pivotal RCT subgroup (illustrative) Benefit was consistent in patients already on ACEi/ARB and in patients not yet on an SGLT2 inhibitor. | iZO Medical Affairs | Step | High | ||
EV-03 · Guideline statement (illustrative) Guidance supports early initiation of kidney-protective therapy when albuminuria is present. | iZO Medical Affairs | StepPA | Moderate | ||
EV-04 · Optum RWE cohort (simulated) Patients whose therapy was delayed over 90 days had 14.8 hospitalizations per 100 patient-years versus 9.6 when started within 30 days. | Optum RWD | StepPATier | Moderate | ||
EV-05 · Optum RWE cohort (simulated) CKD progression events were 9.2 per 100 patient-years when delayed over 90 days versus 6.1 within 30 days. | Optum RWD | StepPA | Moderate | ||
EV-06 · Claims access patterns + payer PA source, to be confirmed (simulated) Across the 6 payer segments, prior-authorization denial rates show a moderate-to-strong positive association with pharmacy abandonment (Pearson r = 0.69). | Optum Claims | PATier | Moderate | ||
EV-07 · Optum HEOR model (simulated) Moving the barrier-affected cohort from the over-90-day to the within-30-day profile would avoid about 2,132 hospitalizations per year. | Optum HEOR | StepPASpecialistQLTier | Moderate | ||
EV-08 · Medical information insight (simulated) HCP inquiries cluster around documentation requirements and therapy sequencing. | iZO Medical Affairs | PAStepSpecialist | Moderate | ||
EV-09 · Optum claims analysis (simulated) Policies restricting prescribing to specialists are associated with longer time to first fill. | Optum Claims | Specialist | Low-Moderate | ||
EV-10 · Optum claims analysis (simulated) Quantity-limit access issues concentrate at first fill. | Optum Claims | QL | Low-Moderate | ||
EV-11 · Optum claims analysis (simulated) Tier-3 placement is associated with higher abandonment at the pharmacy. | Optum Claims | Tier | Low-Moderate |
Evidence coverage
Share of barrier types supported by selected items
100%5 of 5 covered
Step edit
Prior authorization
Specialist-only prescribing
Quantity limit
Tier placement
Confidence56 · Moderate
Average strength points (High 3, Moderate 2, Low-Moderate 1), rescaled to 0–100
PA denial vs pharmacy abandonment
Payer segments (simulated; payer PA source to be confirmed)
r = 0.69 · moderate-to-strong positive association across 6 payer segments. Segment-level, not patient-level causation.