E.V.I.dently January 2019

Message from NPC

Answering Sen. Alexander’s Challenge: Eliminating Waste From Health Spending in the Right Way

In December 2018, U.S. Senate Health, Education, Labor and Pensions Committee Chairman Lamar Alexander (R-TN) sent a letter to a broad swath of heath care stakeholders, asking them for specific suggestions on how to reduce unnecessary spending. In a commentary published in The Hill in response to Sen. Alexander’s letter, NPC President and Chief Executive Officer Dan Leonard, MA, outlines NPC’s ongoing efforts to collaborate with a range of organizations to address health spending issues and reduce low-value care.

NPC Now: A Look at Our Latest Work

NPC Submits Comments to CMS on the International Price Index Model

NPC submitted comments to the Centers for Medicare and Medicaid Services (CMS) on its advance notice of proposed rulemaking regarding the key design considerations for developing the International Price Index (IPI) Model for Medicare Part B drugs. NPC identifies several critical methodological limitations associated with the potential IPI Model design and explained that, given these limitations, the IPI Model should not be among the potential policy options considered by CMS as it will not achieve the agency’s goal of prioritizing value and improved patient outcomes. Instead, NPC offers alternative policy options aimed at addressing health care spending and improving value-based payment.

NPC Comments on CMS Plan to Modernize Medicare Part D and Medicare Advantage

NPC submitted comments to CMS on its proposed rule, Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out-of-Pocket Expenses. NPC’s response focuses on how patients may respond differently to the same treatment and the issues associated with a one-size-fits-all approach to coverage determination, as well as the implications of step therapy.

Value-based Contracts Provide Promise and Potential

In his latest column for Chain Drug Review, Mr. Leonard looks deeper into 2019 and explores how we can take a more holistic approach toward addressing health care spending and getting it under control. Read the column to learn how value-based contracting, improved understanding of costs, reducing low-value care, and regulatory and legislative changes can help drive the health care system in the United States toward greater value for all stakeholders.

How to Tackle Health Spending Without Taking the Easy — and Wrong — Path

When it comes to health care spending, the challenge “is not so much the easy work of cutting medical spending by finding the places where the numbers are biggest.” It’s the “much-harder task of examining — and eliminating — the places in our health care spending where the value delivered is smallest,” writes NPC Vice President of Research Michael Ciarametaro, MBA, in a column published in Morning Consult. He explains why it’s imperative for policymakers to think about costs in relation to benefits and health outcomes.

Research and Info You Need to Know

What’s Been the Bang for the Buck? Cost-effectiveness of Health Care Spending Across Selected Conditions in the US

Spending for six of the top seven causes of death and disease over the last 20 years was both cost-effective and improved patient outcomes, according to a study from NPC and RTI Health Solutions that was published in the January 2019 issue of Health Affairs. The research addresses concerns about the rising cost of health care in the United States and the costs associated with innovative treatments by measuring whether — when considering inflation and disease prevalence — the cost of treatment for the top conditions associated with disability and mortality actually became costlier over time. The results indicate that increased prevalence and inflation account for the majority of cost growth over 20 years, challenging the idea that all health care spending is out of control.

NPC in Health Affairs Blog: Activating Employees in Discussions of Health Care Trade-Offs: It Can Be Done

This NPC-led article published on Jan. 3 in the Health Affairs Blog builds on the findings from NPC’s recent case study on employee participation in benefit design and a previous Health Affairs Blog post that explored the need to make health care decision-making tradeoffs to compensate for shortcomings in the U.S. market-based health system. The article shows how the lessons from health care decision-making by employees could be applied at the health system level.

NPC in The Patient: Patient Community Perspectives on Real-world Evidence: Enhancing Engagement, Understanding and Trust

The expanding use of real-world evidence (RWE) has been the subject of much discussion among clinicians, regulators and payers, but the patient voice is less represented. In an article published in The Patient, NPC and the National Health Council found that while most patients were initially unaware of RWE and its actual or potential uses, patients see great potential in using RWE and think it should be used to inform decision-making. The article flagged key areas that would make RWE more useful and accessible to patients.

ICYMI: Articles of Note

Events and Education

NPC Webinar: “Let’s Get Real: How Will the FDA Framework for Real-world Evidence Impact You?”

Join NPC and experts for a webinar on Jan. 30 from 1 p.m. to 2 p.m. ET that will showcase the potential implications of the U.S. Food and Drug Administration’s (FDA) framework for real-world evidence for patients, payers, manufacturers and other health care stakeholders. The Jan. 30 webinar will provide an overview of how the FDA currently uses RWE and how it may be used in the future, a deeper dive into research on RWE, and payer and industry perspectives on how they approach using RWE. Don’t wait — register now.

NPC @ AcademyHealth 2019 National Health Policy Conference

At AcademyHealth’s 2019 National Health Policy Conference in Washington, D.C., on Feb. 4-5, sponsored by NPC, health care stakeholders will discuss the most critical issues and immediate policy priorities in U.S. health care. The conference includes a panel moderated by NPC Vice President and Chief Executive Officer Robert W. Dubois, MD, PhD, addressing value assessment frameworks and cost effectiveness. Learn more and register now.

NPC @ Paying for Cures: Ensuring Patient Access and System Sustainability

The FDA is approving more targeted and curative therapies, but these complex treatments are often more expensive. MIT’s NEWDIGS FoCUS project brought together a diverse group of health care experts to determine how to finance these curative therapies. During the Feb. 12 Paying for Cures conference, cosponsored by NPC, speakers will outline the financing challenges of curative therapies, share precision financing strategies and tools, and explore solutions to making cures accessible to patients and sustainable for the health care system. Keynote speakers include U.S. Senators Bill Cassidy (R-La.) and Sheldon Whitehouse (D-R.I.).

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. 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. Get more information and sign up to attend.