Message from NPC
Does High Return Call for Greater Investment?
Over the past three decades, advances in medical technology, from medications to devices, have had a profound impact on how patients receive care and manage disease. Although important individual innovations in surgery, diagnostic testing, devices, and drugs have all visibly increased the quality of life and outcomes for patients, which of these types of medical care has provided the greatest overall contribution to improvements in patient outcomes during the past three decades?
National Pharmaceutical Council (NPC) Chief Science Officer and Executive Vice President Robert W. Dubois, MD, PhD, explores that question in his latest column in Morning Consult. According to research published in the Journal of Managed Care & Specialty Pharmacy, pharmaceuticals, which have made up roughly 10-15 percent of our overall health dollar for decades, have driven the majority of medical innovation and improved outcomes for patients when looking at the system overall – raising the possibility that we are actually under-investing in them as the most valuable facet of health technology.
NPC Now: A Look at Our Latest Work
NPC submitted comments on the U.S. Department of Health & Human Services’ (HHS) request for information on its Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. NPC’s comments reflect our mission as a health policy research organization, utilizing peer-reviewed research and evidence-based white papers as the basis for the following recommendations: addressing the barriers to effective value-based contracting, addressing improving transparency with pharmacy benefit management agreements, considering how and by whom value should be determined, exploring alternate financing models, improving data access and considering the long-term value of pharmaceuticals, among other recommendations. Read the full comments on NPC’s website.
Restrictions, Variations in Specialty Drug Coverage May Affect Physician and Patient Choices
According to a new study published in Health Affairs from the Center for the Evaluation of Value and Risk in Health at Tufts Medical Center and NPC, coverage of specialty medicines by major U.S. commercial health plans varies widely. The study’s findings point to the need for greater transparency in the evidence used to determine plan coverage decisions, given the wide variations in plan coverage and restrictions, and have implications for both patients and providers.
Are Payers Ready to Address the Financial Challenges Associated with Gene Therapy?
While gene therapies hold the promise of substantial benefits, “some patients will face barriers accessing them due to the nature of the clinical intervention, the characteristics of the U.S. insurance system, and the interaction between the two.” A new article published on the Health Affairs Blog, written by NPC and the Analysis Group, explores these tensions in our health care system via online market research with payers and highlights a few proposals to address these concerns.
NPC and Duke-Margolis Center for Health Policy Announce Taruja Karmarkar as New Health Policy Fellow
NPC and Duke University's Robert J. Margolis, MD, Center for Health Policy announced that Taruja Karmarkar, PhD, has been named the 2018-20 post-doctoral health policy fellow. Dr. Karmarkar’s research focuses on the impact of policy proposals on access to pharmaceuticals and using observational study design to examine the utilization and value of specialty medicines. Learn more about Dr. Karmarkar and the Duke Margolis-NPC Post-Doctoral Health Policy Fellowship.
Research and Info You Need to Know
Dig Into Health Spending Issues: Subscribe to the Going Below the Surface E-newsletter
One of the most pressing issues facing our nation is how to optimize health care spending in a way that sustains next-generation innovation while continuing to improve overall patient well-being and health system efficiencies. NPC’s recently launched e-newsletter, Going Below the Surface, is solely focused on this vital issue. Subscribe today to begin receiving timely updates about relevant peer-reviewed journal articles, commentary on emerging trends and themes that relate to the broader issue of health care spending in the United States.
Health Affairs Launches Council on Health Care Spending and Value
With total health care spending reaching nearly 18 percent of the GDP, Health Affairs has launched a Council on Health Care Spending and Value to ignite and provide a focal point for discussion, analysis and action surrounding the topic of health care spending. Supported by NPC and Anthem, Inc., the Council will be an integral part of Health Affairs’ “Considering Health Spending” initiative, which also includes a special series in both the journal and blog (also supported by NPC). Dr. William Frist, former majority Leader of the U.S. Senate, and Dr. Margaret Hamburg, former commissioner of the U.S. Food and Drug Administration, will chair the committee.
NPC in Specialty Pharmacy Times: Going Below the Headlines on Health Spending in Four Steps
Anyone who reads the headlines on health spending will see a parade of “usual suspects” cited as the problem, but often, the headlines can make the problem itself a moving target. When it comes to health spending, real problem-solving will only happen if all stakeholders dig deep into the issues at hand within a broadly understood framework to truly understand what is driving health spending. In his latest commentary for Specialty Pharmacy Times, NPC President Dan Leonard offers four suggestions to reconsider how we assess, analyze and apply the evidence and data around health spending to foster productive conversation.
ICYMI: Articles of Note
- Neumann PJ, Cohen JT. QALYs in 2018—Advantages and Concerns. JAMA. June 26, 2018.
- Agarwal R, Gupta A, Fendrick AM. Value-Based Insurance Design Improves Medication Adherence Without An Increase In Total Health Care Spending. Health Affairs. July 2018.
- National Academies of Sciences, Engineering and Medicine. Examining the Impact of Real-World Evidence on Medical Product Development: II. Practical Approaches: Proceedings of a Workshop—in Brief. July 11, 2018.
- Neumann PJ, Weissman H. The FDA’s New Guidance On Payer Communications: Implications For Real-World Data And Value-Based Contracts. Health Affairs Blog. July 17, 2018.
Events and Education
FT Pharma Pricing and Value Summit: Debate the Future of Pharma Pricing
At the inaugural FT Pharma Pricing and Value Summit, attendees will hear firsthand how leaders from across the pricing and market access landscape are addressing key challenges through competition, collaboration and regulation. Join them in New York on Sept. 13 to explore the future of pharmaceutical pricing and market access in an evolving healthcare environment. E.V.I.dently readers can save 20% when registering with the discount code NPC20.
NPC Webinar Archive: Barriers to Paying for Value
NPC’s recent webinar, "Barriers to Paying for Value," highlighted its paper examining how regulatory barriers limit value-based contracting. The webinar discussed barriers to financing curative therapies, a comprehensive solution for Medicaid’s Best Price policy and took a deeper dive into the anti-kickback statute. Watch the webinar via NPC’s website.
Webinar Archive: Current IRS Policy on High-Deductible Health Plans: Impacting Americans with Chronic Conditions
If you missed last month’s National Health Council webinar, co-sponsored by NPC, on a recent NPC-funded study examining how current IRS policy on high-deductible health plans and health savings accounts impacts Americans living with chronic conditions, the webinar archive is now available online. Dr. A. Mark Fendrick, director of the University of Michigan's Center for Value-Based Insurance Design, presented findings from the study and hosted an audience question-and-answer session.