Message From NPC
A Health Care Wish List for 2020
In his latest column for Chain Drug Review, National Pharmaceutical Council President and CEO Dan Leonard reflects on the health policy issues he hopes will be addressed in 2020. “Rather than make predictions in this column,” Mr. Leonard writes, “this year I’m outlining a wish list for the health care sector, actions we can all take to make health care more efficient, reduce wasteful spending, ensure greater value for our health care dollars, and break down barriers that block patient access to medicines.” Read what made the list and how we can address these topics on the Chain Drug Review website.
NPC Now: A Look at Our Latest Work
NPC President Discusses Value Assessment Frameworks in STAT Commentary
When it comes to determining the value of treatments, what are the strengths and weaknesses of the value assessment frameworks decision-makers are using? In a STAT commentary, Mr. Leonard says there is no one “best” framework to measure value and, given the potential impact on patient access to care, multiple frameworks should be used to inform decisions.
- NPC’s recent analysis, “Current Landscape: Value Assessment Frameworks,” examines how existing frameworks compare and contrast, through the lens of six broad categories: development process, measures of benefit, measures of cost, methodology, evidence and assessment process.
- In a blog post, the Society for Women’s Health Research (SWHR) discussed NPC’s landscape analysis and outlined why relying on one framework alone can hinder efforts to advance women’s health.
- In an interview with NPC, SWHR’s vice president of public policy, Sarah Wells Kocsis, MBA, spoke about their approach to value assessment and what SWHR hoped to hear from the Institute for Clinical and Economic Review (ICER) during their recent public meeting on migraine treatments.
Experts Discuss How to Define and Navigate Low-Value Care
How can stakeholders address the $340 billion problem of low-value care? On Jan. 15, the Going Below The Surface (GBTS) Forum, in conjunction with Forum partners AcademyHealth and NPC, hosted a webinar to discuss challenges in identifying low-value care and how to eliminate it. The GBTS Forum is working to develop a roadmap, slated to be rolled out in early spring, to better equip stakeholders to navigate the issue. Read the webinar recap and stay up-to-date on health spending issues by subscribing to the Going Below The Surface e-newsletter.
Other Research and Info
New Standards Published to Guide Health Plan Decision-Making
The January 2020 edition of Journal of Managed Care and Specialty Pharmacy features articles summarizing important takeaways from two Academy of Managed Care Pharmacy (AMCP) Forums that examined different aspects of health plan coverage decision-making:
- Proceedings from AMCP’s Partnership Forum, “Principles for Sound Pharmacy and Therapeutics (P&T) Practices: What’s Next?,” offer updated best practices for P&T committees. The recommendations may help address the significant variation in the consistency, volume and types of evidence reviewed and cited in coverage decisions, identified in an earlier study from NPC and the Center for the Evaluation of Value and Risk in Health at Tufts Medical Center
- The second AMCP Partnership Forum, “Optimizing Prior Authorization for Appropriate Medication Selection,” outlined recommendations designed to help health plans ensure that prior authorization and step therapy, common methods for managing drug utilization, don’t stand in the way of timely, appropriate and evidence-based care for patients.
In late December, AMCP published the final Format for Formulary Submissions - Guidance on Submission of Pre-approval and Post-approval Clinical and Economic Information and Evidence, Version 4.1. NPC’s Vice President Jennifer Graff, PharmD, participated in AMCP’s Jan. 23 webinar to discuss the new guidance, which outlines how biopharmaceutical manufacturers and health plans can exchange high-quality clinical and economic information about treatments over the course of a product’s lifecycle.
New Report Captures How Employers Expect to Tackle Drug Utilization
More than half of Americans get their health insurance through their employers, making employer attitudes on drug pricing, contracting issues, benefit design, and formulary decisions a critical element in the broad push for value in healthcare. With support from NPC, the National Alliance of Healthcare Purchaser Coalitions has released a new report, Employer Roundtables on Drug Management, capturing findings from an employer survey and roundtables they conducted with more than 80 large employers in the U.S. The report highlights NPC’s Resource Guide for Healthcare Purchaser Coalitions and summarizes key recommendations for employers, policymakers and health policy researchers.
ICYMI: Articles of Note
- Matthew Sussman, Jeffrey C. Yu & Joseph Menzin. Do Research Groups Align on an Intervention's Value? Concordance of Cost-Effectiveness Findings Between the Institute for Clinical and Economic Review and Other Health System Stakeholders. January 10, 2020, Applied Health Economics and Health Policy
- David M. Kent, MD, MS, et al. The Predictive Approaches to Treatment effect Heterogeneity (PATH) Statement. January 7, 2020, Annals of Internal Medicine
Ethan Basch, MD, MSc; Lalan Wilfong, MD; Deborah Schrag, MD, MPH. Viewpoint: Adding Patient-Reported Outcomes to Medicare's Oncology Value-Based Payment Model. January 2, 2020, JAMA
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, moderated by NPC Chief Science Officer Robert Dubois, MD, PhD.
Webinar: Driving Evidence-Based Health Plan Coverage by Recognizing Gaps, Updating Practices – On Feb. 13 at 12 p.m. ET, 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. Register online today!