One of the most consequential downstream effects, Miller argued, is the way DSM diagnoses become tightly coupled to FDA drug approvals—and, by extension, insurance coverage decisions. Although the FDA appropriately requires a clear diagnostic target when evaluating medications, DSM diagnoses themselves are fluid and subject to change as scientific understanding evolves. Despite this, coverage may still be denied because “the drug’s not FDA approved for that” indication. Psychiatric Times. Psychiatric Times.