E.V.I.dently February 2019

Message from NPC

How Can We Advance Progress in Moving From Volume to Value in Health Care?

This year, it appears that many of the health care issues that rose to prominence in 2018 will continue to be front and center. The Trump administration is pressing ahead with the U.S. Department of Health & Human Services Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs, and both the newly elected and re-elected members of Congress have pledged to keep up the pressure on health care spending, with a particular focus on biopharmaceuticals. The actions taken during the next few months could affect the future of the American health care system in both the short and long term.

In his latest column in Specialty Pharmacy Times, NPC President and Chief Executive Officer Dan Leonard explains that rather than trying to score news headlines, what we need is a thoughtful, research-based approach to tackle the health care challenges ahead of us. Read the full column to see Mr. Leonard’s suggestions on how we can address the issues raised in the administration’s blueprint and move toward a more value-based health care system.

NPC Now: A Look at Our Latest Work

NPC Submits Comments on FDA Framework for a Real-World Evidence Program

In response to the U.S. Food and Drug Administration (FDA) request for feedback on its Framework for a Real-World Evidence Program; Availability, on Feb. 5, NPC provided comments describing methods and standards for observational studies that can be foundational for the FDA, as well as the need for refined definitions of real-world evidence (RWE) and data, a clear vision, and a timeline for the multifaceted RWE program, among other issues. For stakeholders still considering comment, the comment period has been reopened for 60 days.

Research and Info You Need to Know

Value-based Agreements Are More Prevalent Than We Thought, Per AJMC Study

As the health care system in the U.S. continues to transition from volume to value, research published last week in the February 2019 edition of The American Journal of Managed Care shows that value-based agreements (VBAs) between payers and biopharmaceutical manufacturers may be more prevalent than previously assumed. Researchers from the Duke-Margolis Center for Health Policy and NPC surveyed payers and manufacturers to get a better understanding of the prevalence of these agreements, finding that consideration of VBAs as a coverage and payment tool is increasing, but only around one in four is disclosed to the public. The research also shows that there are significant hurdles to overcome in the negotiation process and outlines the factors that can lead to successful agreements.

What’s in a Number? It Matters in Health Policy Conversations

study published in Value in Health from IQVIA and NPC takes a deeper dive on the data sources and methods behind a wide range of prescription medicine spending estimates from the Centers for Medicare and Medicaid Services, America’s Health Insurance Plans, Kaiser Family Foundation, the BlueCross BlueShield Association, and the Massachusetts Health Policy Commission. The study found important differences in the underlying data and approaches, which account for the variation in the estimates. Read more about the policy implications of health spending estimation methods in NPC’s blog.

NPC Continues to Weigh in on ICER’s Methods Via Comments on Draft Unsupported Price Increase Assessment Protocol and “Valuing a Cure”

In comments submitted to the Institute for Clinical and Economic Review, NPC voiced its concerns about ICER’s one-sided approach and methods outlined in the draft “unsupported price increase” assessment protocol. NPC noted ICER’s lack of focus on the rest of the health system and evaluated the protocol through the lens of our Guiding Practices for Patient-Centered Value Assessment. NPC also plans to submit comments on ICER’s Valuing a Cure project methodology, which are due on Feb. 20.

Paying for Cures: Ensuring Patient Access and System Sustainability

One of the most vexing challenges facing the U.S. health care system is how payers and biopharmaceutical innovators can work together to ensure that curative treatments — such as gene therapies and immunotherapies — are more broadly accessible to patients. During a daylong conference, “Paying for Cures,” held in Washington, D.C., on Feb. 12, more than 250 participants gathered to discuss this topic.

Led by MIT’s NEWDIGS FoCUS (Financing and Reimbursement of Cures in the US) initiative and supported by NPC and others, the conference considered the current health care environment, barriers to care and potential solutions to ensuring patient access to transformative therapies that are often challenging to develop and higher in cost. Read more about the conference on NPC’s website.

ICYMI: Articles of Note

Events and Education

NPC Webinar: Amplifying the Patient Voice: Policy Solutions for Improving Patient-reported Measures in Oncology Value-based Payment Programs

Join us for a webinar on Feb. 28 from 2 p.m.-3:30 p.m. ET to explore recommendations for improving patient-reported oncology measures for use in value-based payment programs. NPC and Discern Health will host an expert panel of stakeholders led by Drs. Mark McClellan, Director, Duke-Margolis Center for Health Policy, and Ethan Basch, Director, Cancer Outcomes Research Program, UNC Lineberger Comprehensive Cancer Center, to discuss action steps for better incorporating the patient voice in value-based care. The panel will also discuss an upcoming NPC-Discern white paper, Improving Patient-reported Measures in Oncology, addressing the same topic. Get more information and sign up to attend.

NPC @ National Quality Forum Annual Conference

Join NPC at the National Quality Forum’s Annual Conference in Washington, D.C., on March 24-26. The event, which is co-sponsored by NPC, will focus on the latest topics in health care quality and policy. Be sure to stop by NPC’s display, where copies of NPC’s forthcoming papers, Development of a Medication Access Framework for Quality Measurement and Improving Patient-reported Measures in Oncology, will be available.

NPC @ Academy of Managed Care Pharmacy Annual Meeting 2019

The 2019 Academy of Managed Care Pharmacy Annual Meeting will be held on March 25-28 in San Diego, California. NPC Vice President of Comparative Effectiveness Research Jennifer Graff, PharmD, will address “Patient-Reported Outcomes and Patient Preferences: Considerations for Coverage Policy Decisions?” on March 26 at 4:30 p.m. In addition, two posters on patient access to medication based on research co-authored by NPC will be presented on March 27 at 11:30 a.m. Learn more and register now.

NPC @ Health Datapalooza 2019

NPC is co-sponsoring AcademyHealth’s Health Datapalooza conference on March 27-28 in Washington, D.C. Registration is open now for in-person and online attendance.