Message from NPC
In his latest commentary for Chain Drug Review, NPC President and Chief Executive Officer Dan Leonard considers the challenges in measuring and paying for value in health care, particularly when it comes to biopharmaceuticals. Read the commentary to learn how looking at the full course of treatment, not just a snapshot, can lead to a more complete understanding of value.
NPC Now: A Look at Our Latest Work
NPC to CVS: Join Us in a Broader Dialogue to Address Health Care Spending
CVS Health recently announced it would allow employers to exclude from their formularies medicines launched at a price greater than $100,000 per Quality-Adjusted Life Year (QALY). NPC Chief Science Officer and Executive Vice President Robert Dubois, MD, PhD, says in an article published in the Health Affairs Blog that just using a single cost-effectiveness threshold misses elements of value important to patients and could hamper patient access to innovative medicines. In a blog posted on our website, NPC extended an invitation to CVS to continue the discussion and join us in a conversation on tackling health spending with the Going Below the Surface initiative.
NPC in Specialty Pharmacy Times: Inconsistent Specialty Pharmaceutical Coverage Threatens Care Coordination, Continuity
Specialty pharmaceuticals hold much promise for treating patients with chronic diseases, from Crohn’s disease to cancer, from hemophilia to HIV. But inconsistency in insurance coverage decisions, combined with churn in the U.S. insurance marketplace, threatens the care coordination and continuity that renders these treatments most effective. In his latest column for Specialty Pharmacy Times, Mr. Leonard explores new research published in Health Affairs that sheds light on when and how payers cover specialty medications.
Amplifying the Migraine Community's Voice in ICER's Value Assessment Process
In an interview with NPC, Lindsay Videnieks, director of the Headache and Migraine Policy Forum (HMPF), discusses the kind of effort it takes to become involved in the ICER value assessment process, what her organization learned along the way and how ICER’s patient engagement process could be improved.
Research & Info You Need to Know
Health Affairs Blog Article Highlights Trouble with Expanding Step Therapy Protocols to Specialty Medications Among Medicare Advantage Programs
A Health Affairs Blog article published earlier this month, “Variation In The Use Of Step Therapy Protocols Across US Health Plans,” explores potential issues associated with the Centers for Medicare and Medicaid Services announcement permitting Medicare Advantage plans to employ step therapy protocols for specialty medications beginning in 2019. The article highlights research conducted by NPC and the Center for the Evaluation of Value and Risk in Health at Tufts Medical Center describing the wide variation in step therapy protocols among commercial health plans and calls for greater transparency in the rationale and evidence used for payment decisions.
ICYMI: Articles of Note
- National Association of ACOs. Estimates of Savings by Medicare Shared Savings Program Accountable Care Organizations. August 30, 2018.
- Corrigan-Curay J, Sacks L, Woodcock J. Real-World Evidence and Real-World Data for Evaluating Drug Safety and Effectiveness. JAMA. September 4, 2018.
- Commonwealth Fund. Issue Brief: Pharmaceutical Reference Pricing: Does It Have a Future in the U.S.? September 10, 2018.
- PhRMA. Milliman Study on the Utility of ICER Reports for Private Payer Drug Coverage Decision-Making. September 18, 2018.
- Frost A, Barrette E, Kennedy K, Brennan N. Health Care Spending Under Employer-Sponsored Insurance: A 10-Year Retrospective. Health Affairs. September 19, 2018.
Events and Education
Webinar: Starting a Serious Conversation About Health Care Spending: What Can We Learn From the Past and From Elsewhere?
Mark your calendars for Oct. 18 at 12 p.m. Eastern Time, when AcademyHealth and NPC will host a webinar, “Starting a Serious Conversation About Health Care Spending: What Can We Learn From the Past and From Elsewhere?” Corinna Sorenson of Duke University and Craig Mitton of the University of British Columbia will discuss new research examining the differences between European and U.S. spending models, including budget thresholds. Get the details and register now on NPC’s website.
NPC @ ISPOR Summit 2018: New Approaches to Value Assessment: Towards More Informed Pricing in Healthcare
Dr. Dubois will speak at the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) summit, “New Approaches to Value Assessment: Towards More Informed Pricing in Healthcare,” on Oct. 19 in Washington, D.C. The summit will explore and debate both standard and more recently proposed approaches to measuring value and how they could be used in pricing and coverage decisions. Learn more on NPC’s website.
NPC @ Value-based Health Care Congress 2018
Join NPC at the sixth annual Value-based Health Care Conference (VBHCC), hosted by World Congress in Alexandria, Va., on Oct. 22-23. The VBHCC offers four co-located summits focusing on different areas of health care, but Mr. Leonard will be a panel speaker at the cross-industry keynote panel on Oct. 23, addressing attendees of all four summits as part of a panel to “Understand Network Partner Priorities to Strengthen Value-based Arrangements and Outcomes.” Registration details are available on NPC’s website.
NPC @ AMCP Nexus 2018
Join NPC at the Academy of Managed Care Pharmacy (AMCP) Nexus 2018 meeting in Orlando, Florida, on Oct. 22-25. Don’t miss the panel on “Using Online Real-World Evidence Tools to Enhance Formulary Decision-Making,” featuring NPC Vice President of Comparative Effectiveness Research Jennifer Graff, PharmD, on Oct. 24 at 8 a.m. An abstract based on NPC-sponsored research, “Access to Care Roundtable – Defining a conceptual framework of medication access and quality measurement,” also will be presented on Wednesday, Oct. 24, at 12:30. See details and register now for AMCP Nexus 2018.
NPC @ eyeforpharma Value Summit 2018
At the eyeforpharma Value Summit 2018, held on Nov. 7-8 in Philadelphia, attendees will expand their use of real-world evidence, collaborate with stakeholders, master technological disruption and work to secure value-based agreements. Don’t miss the panel discussion on “The Roadmap to Scale VBC,” moderated by NPC’s Mr. Leonard, on Nov. 7. Get the full details and registration link online.
NPC @ National Alliance of Healthcare Purchaser Coalitions 23rd Annual Forum
The National Alliance of Healthcare Purchaser Coalitions’ 23rd Annual Forum, held Nov. 12-14 in Washington, D.C., features an innovative agenda offering employers and other health care purchasers’ insights and value-based strategies on the latest trends and applicable solutions to more cost-effectively manage health benefits to improve health and well-being for employees, their families and communities. Be sure to catch Dr. Dubois moderating the closing panel, “Healthcare Spend: Going Below the Surface to Define our Path Forward,” on Nov. 14 at 11:30 a.m. Learn more and register now.
NPC @ PQA Social Determinants of Health Forum: Exploring Medication Access and Quality
As our health system continues to move towards value-based care, health care stakeholders are progressively regarding the social determinants of health as critical components of value. At the Pharmacy Quality Alliance’s Social Determinants of Health Forum: Exploring Medication Access and Quality in Alexandria, Va., on Nov. 14-15, sponsored by NPC, attendees will discuss the impact of social determinants of health, including medication access, quality and much more. The forum will feature forthcoming NPC-sponsored research on quality measurement, and NPC Vice President of Health Services Research Kimberly Westrich will open the day’s discussions on Nov. 15. Registration is open to PQA members and non-members.
14th Annual Personalized Medicine Conference: Preparing for the New Possible
At the 14th Annual Personalized Medicine Conference: Preparing for the New Possible, sponsored by NPC, the world’s leading researchers, investors, industry executives, policy experts, payers, clinicians, and patient advocates will convene on Nov. 14-15 in Boston to define the landscape and outlook for personalized medicine in science, business and policy. Visit NPC’s website for registration information.