E.V.I.dently December 2019

Message From NPC

Though 2019 might be coming to a close, the noisy debate over health spending and other pressing health policy issues shows no signs of quieting down. At NPC, we’ve been heartened to see stakeholders from across the landscape come together for a different kind of conversation. Through the Going Below The Surface initiative, patient groups, payers, providers, employers and life science organizations have all convened to drive meaningful conversations and rigorous health policy research that can help inform good decisions. We were proud to see NPC-supported research put to good use, informing a discussion about the impact of cost-sharing strategies. The discussion culminated in an update to IRS guidelines that will lower barriers to medication access for patients with chronic disease and potentially lower costs.

Over the last few years, there has been a steady flow of headlines reporting on innovative, life-changing therapies developed by biopharmaceutical companies. For our team here at NPC, each leap forward has underscored the growing impact of innovation on the lives of patients and the imperative behind our efforts to generate high-quality health policy research and analysis.

As we reflect on 2019 and look ahead to 2020, I hope you will continue to follow NPC’s work and join us in fostering research-driven discussions. Stay up-to-date by following us on Twitter and LinkedIn, and encourage others to do the same by subscribing to our news and updates.

NPC Now: A Look at Our Latest Work

NPC Comments on ICER’s Efforts to Widen Scope to Non-Drug Topics

NPC submitted comments to the Institute for Clinical and Economic Review (ICER) to inform their efforts to widen the scope of 2020 assessments to include non-drug treatments. To date, ICER has focused almost entirely on drug assessments, though medicines comprise only 16 percent of all health care spending. NPC’s comments offered input on topic selection criteria, priority topics and the importance of identifying low-value care. ICER’s move to assess non-drug treatments addresses NPC’s long-standing recommendation that value assessment reflect the full spectrum of care provided to patients and include all types of health care interventions.

NPC Submits Comments to CMS on Oncology Care First Model

NPC weighed in on the Centers for Medicare and Medicaid Services (CMS) Center for Medicare and Medicaid Innovation’s potential new value-based payment model designed to support “high-quality oncology care.” The model would test approaches to paying for cancer and cancer-related care for Medicare beneficiaries. NPC’s comments focused on multiple areas, including the importance of patient involvement in all phases of program development and concerns over the exclusion of cell and gene therapies from episode payments. NPC’s comments reflected findings from prior NPC research, including Improving Patient-Reported Outcomes in Oncology and Improving Oncology Quality Measurement in Accountable Care.

Lawmakers Initiate Push for Cures 2.0 with Public Input

U.S. Representatives Fred Upton (R-MI) and Diana DeGette (D-CO) called for public feedback on Cures 2.0, legislation intended to build on the 21st Century Cures Act. NPC’s comments focused on several key areas, including 1) the need to expedite coverage for new cures and medical products by addressing legislative and regulatory barriers, 2) the need for federal programs to incorporate real-world evidence into health care payment decisions, and 3) the need to incorporate information from patient and family voices in coverage decisions and payment incentives.

NPC Fellows Offer Tips for Candidates Applying for 2020-2022 Position

To help candidates developing their applications for the 2020-2022 NPC-Duke Margolis Health Policy Fellowship, NPC asked current and former fellows to share insights from their experiences and tips for prospective fellows. Current health policy fellow Taruja Karmarkar, PhD, and her predecessors, Ilene Hollin, PhD, MPH, Assistant Professor at Temple University’s College of Public Health, and Chuck Shih, PhD, MS, Director of Public Payer and Health System Strategy at Biogen, offered perspectives on how the fellowship impacted their career paths, their experience working with academic partners, and their advice to aspiring health policy graduates. Review of applications will begin on January 15, 2020 and will continue until the position is filled. The fellowship begins on July 1, 2020.

Other Research and Info

ICER’s Reliance on QALYs a Red Flag for the Alliance for Aging Research 

NPC President and Chief Executive Officer Dan Leonard spoke with Sue Peschin, MHS, President and CEO at the Alliance for Aging Research, about value assessment and the needs of older patients. Ms. Peschin flagged concerns that existing frameworks fail to adequately capture the unique choices facing patients with multiple comorbidities and that ICER’s use of quality-adjusted life years (QALYs) to measure cost-effectiveness takes treatment options off the table for doctors and their patients.”

ICYMI: Articles of Note

  • Garry EM, et al. Actionable Real-World Evidence to Improve Health Outcomes and Reduce Medical Spending Among Risk-Stratified Patients with Diabetes. December 2019, Journal of Managed Care & Specialty Pharmacy
  • Hartman M, et al. National Health Care Spending in 2018: Growth Driven By Accelerations In Medicare And Private Insurance Spending. December 5, 2019, Health Affairs
  • Expanding Use of Multi-Criteria Decision Analysis for Health Technology Assessment. December 2019, The American Journal of Managed Care


Mark your calendar now and kick off 2020 with great health policy discussions!

  • Webinar: Going Below The Surface (GBTS) on Low-Value Care – Building upon previous efforts aimed at reducing low-value care, GBTS partners have developed a roadmap to guide health care stakeholders as they consider and implement low-value care interventions. This first of a series of webinars on the topic will assist in defining and understanding low-value care and its importance to various stakeholders. Join us on Wednesday, Jan. 15, 2020, for this webinar, hosted by AcademyHealth and the GBTS Forum.
  • Webinar: Variations in Use of Evidence – In February, experts from NPC and the Tufts Center for the Evaluation of Value and Risk in Health will discuss their recent study published in Health Affairs that revealed significant variation in the consistency, volume and type of evidence being cited by U.S. commercial health plans in coverage decisions for specialty medicines. Watch NPC’s events page for registration details.
  • 2020 National Health Policy Conference (NHPC) – NPC is a sponsor of AcademyHealth’s 2020 NHPC, which will be hosted in Washington, D.C., on Feb. 10-11. The conference will feature discussions on the costs of care, quality improvement, social determinants of health, value-based payments and the role of data in informing health policy. Be sure to stop by NPC’s exhibit table and check out the session on health spending, featuring NPC’s chief science officer, Robert Dubois, MD, PhD.