CER Daily Newsfeed®

Articles

Loud and Clear: Key Takeaways from a Webinar on "Amplifying the Patient Voice" in Quality Measurement (3/21, National Pharmaceutical Council: E.V.I.dently Today) comments “The National Pharmaceutical Council and Discern Health held a webinar on Feb. 28, 2019, to explore ‘Policy Solutions for Improving Patient-Reported Measures in Oncology Value-Based Payment Programs.’...Led by the co-chairs of the roundtable, Drs. Mark McClellan, Director, Duke-Margolis Center for Health Policy, and Ethan Basch, Director, Cancer Outcomes Research Program, UNC Lineberger Comprehensive Cancer Center, the webinar provided an overview of findings described in the white paper and explored action steps necessary to pursue key policy recommendations and bring the patient voice into oncology value-based payment programs.” Full | Webinar Video

Understanding The Burning Platform Of Health Care Spending Growth (3/21, Bill Frist and Margaret Hamburg, Health Affairs Blog) comments “...Without some constraints on spending growth, we believe we will not be able to achieve a health care sector in this country that produces health and well-being for all. That is the burning platform upon which we stand, and it is why we have agreed to be part of the Council on Health Care Spending and Value. It will be the council's job to elevate and normalize a discussion about the fact that health care resources are not—and must not be seen as—unlimited. We must recognize that the US, alone among wealthy nations, has no formal mechanisms for collectively considering, let alone deciding upon, the relative merits of each additional dollar spent on health care.” Full

FTC Data Privacy Probe (3/21, Darius Tahir, Politico Morning eHealth) reports “...Joe Selby is stepping down as executive director of the Patient-Centered Outcomes Research Institute at the end of the year. He's spent eight years running the institute. The organization has had some influence in the digital health world, requiring grant recipients to share data, and funding research into tele-psychiatry.” Full

Some ADHD Medicines May Increase Psychosis More than Others, ‘Real-World' Data Show (3/20, Matthew Herper, STAT) reports “...[Harvard Medical School professor Sebastian Schneeweiss] said in an interview that Aetion was founded because of ‘a huge demand for real-world evidence that comes close to causal conclusions’ and that such an effort, which required well-paid software engineers, couldn't have come together within Harvard. The company is working with the Food and Drug Administration to see if its databases can replicate the results of randomized trials, which randomly assign patients to one treatment or another.” Full

Yale Researchers Awarded $40 Million to Study Opioid Addiction Treatments (3/21, Ziba Kashef, Yale News) reports “...Drs. Ismene Petrakis and Sandra Springer are co-principal investigators leading the research, which is supported by the Veterans Affairs Cooperative Study. Their study will compare the effectiveness of two forms of buprenorphine, an FDA-approved medication to treat opioid-use disorder. Nine hundred veterans at 20 VA sites will receive either a long-acting injectable or oral form of buprenorphine. The researchers will follow the veteran participants for one year, followed by a longer study period to assess treatment retention and opioid abstinence.” Full

Are Prior Authorization Insurance Requirements Killing Patients? (3/20, Barbara McAneny, The Baltimore Sun) comments “...Prior authorization processes should be evidence-based, transparent, electronic and immediate. The plans should monitor their prior authorization processes and remove that requirement entirely when they find that a procedure is never denied or a practice is never denied...In additional survey results released last week, physicians report an increase in the number of prescriptions and procedures that require prior authorization. And fully 85 percent said prior authorization is still disrupting continuity of care.” Full

Health Technology Assessments And the Trouble With Rare Disease Treatments (3/21, Francesca Bruce, Pink Sheet) reports “...Health technology appraisal agencies are struggling to adapt to the challenges of evaluating rare disease treatments, particularly advanced therapies. If companies want a better chance at succeeding in appraisals, they need to help agencies overcome those difficulties, for example, by agreeing to provide longer-term evidence and being upfront about what products can really deliver, according to Sheela Upadhyaya, of England's HTA body NICE.” Paid Subscription Required

Journals

The Evolution of European HTA and Access to Innovative Medicines Kate Kolotourou, Petra Ermacora & Alexander Grosvenor March 20, 2019, Journal of Comparative Effectiveness Research Journal of Comparative Effectiveness Research

Events

17th Annual Eyeforpharma Philadelphia April 16 - 17, 2019 Pennsylvania Convention Center Eyeforpharma

Articles

Tackling Low-Value Care Will Take A Group Effort (3/19, Going Below the Surface) comments “Paying for treatments that don't offer real value for patients is a pervasive problem in the United States, with as much as $340 billion being spent on this low-value, or unnecessary care alone. Eliminating low-value care and its costs to our health care system has taken on even greater importance with health care spending reaching more than 18% of GDP. During a briefing with partners of the Going Below The Surface Forum, three leaders in the effort to reduce low-value care in the United States explained why this has been such a tough challenge to tackle.” Full

PCORI Funds Studies on Shared Decision Making (3/20, David Raths, Healthcare Innovation) reports “...The newly approved shared decision-making awards, funded through PCORI's Dissemination and Implementation initiative, are: $2.1 million for a Kaiser Permanente initiative to implement the use of a decision aid for use by primary care physicians and surgeons as well as their patients who are managing their obesity and who are eligible for and considering weight-loss surgery...$1.7 million for a UCLA project to implement a shared decision making approach for diabetes prevention within two health systems, UCLA Health and Intermountain Health.” Full

Adherence to COPD Treatment Lower With 3 Inhalers Compared With 2 (3/20, Jaime Rosenberg, The American Journal of Managed Care) reports “...‘Although health outcomes were not recorded during this study, nonadherence has been suggested to impact the effectiveness of triple therapy and therefore improving adherence and persistence through simplification of therapy may improve health outcomes for patients with COPD,’ wrote the researchers.” Full

Canada Plans New Agency To Negotiate Drug Prices & Tackle Soaring Costs (3/20, Ian Schofield, Pink Sheet) reports “...The budget does not go into great detail on how the agency would operate, although it is likely to be along the lines described in the advisory council's interim report published earlier this month. That report said the agency's functions would include conducting health technology assessments, negotiating drug prices and listing terms with manufacturers, monitoring real-world safety and efficacy of prescription drugs, and developing and managing the national formulary.” Paid Subscription Required

UK: The Shadow of Brexit on Speed of Access (3/20, Leela Barham, PharmaPhorum) comments “...An earlier analysis by Parexel, covering up to March 2018, found that there was a statistically significant increase in non-submissions to the SMC after Brexit. Looking at non-submissions up to December 2018, the trend shows no sign of abating. It's hard to know if there is a specific ‘Scottish' effect given there isn't a statistically significant trend for NICE. That said, NICE just takes a lot longer so any Brexit effect may be taking longer to be felt.” Full

Press Releases

PCORI Board Approves $3.8 Million to Support Implementation of Findings from PCORI-Funded Research (3/19, PCORI Press Release) “...‘Shared decision making is a vital component of patient-centered care, and it's also a channel building patient-centered evidence into an individual's decision making about their treatment options,’ said PCORI Executive Director Joe Selby, MD, MPH. ‘PCORI is dedicated to supporting research that improves the process by which patients, working with their clinicians, choose a treatment approach that works best for them. “Works best for them” means that the decision is based to the greatest extent possible on patient-specific information. That is the kind of evidence PCORI aims to produce. These new awards will help bring this evidence directly to patients, to support them in making choices with their clinicians about their care.’” Full

Scientist.com and ZRx Outcomes Research Inc. Partner to Offer Online Access to Health Economic and Outcomes Research (HEOR) (3/20, Scientist.com Press Release) “...‘Many research organizations are now using HEOR and RWE datasets to optimize market access, reduce research costs and enable value-focused healthcare decisions,’ said Kevin Lustig, PhD, Scientist.com CEO and Founder. ‘ZRx has developed powerful models to identify patient subsets that will benefit the most from new or existing therapies and to determine whether modifications in treatment protocols can improve human health or product economics.’” Full

Journals

Evidence-Based Medicine-Not a Panacea for the Problems of a Complex Adaptive World Sturmberg JP March 19, 2019, Journal of Evaluation in Clinical Practice PubMed

Articles

International Drug Pricing Index Model Could Restrict Innovation, Access (3/15, Dan Leonard, Specialty Pharmacy Times) comments “...[H]igh drug prices continue to be a hot button issue. The latest in a series of proposed fixes is the idea of tying American drug prices to an international pricing index. This proposal, outlined by [CMS] in late 2018, would undermine CMS' stated goal of prioritizing value and improved patient outcomes over utilization and sickness...The IPI model, as outlined, has critical methodological limitations that would have numerous adverse consequences, leading to restrictions in health care innovation and impeding patient access to needed health care services and products.” Full

PQA Unveils New Medication Access Framework (3/19, Chain Drug Review) reports “...The framework is the centerpiece of a PQA report, ‘Access to Care: Development of a Medication Access Framework for Quality Measurement,’ released today. The report is the product of PQA's Access to Care Roundtable, a multi-stakeholder panel of experts in social determinants of health, healthcare quality improvement and quality performance measurement. The roundtable and report were possible through support from the National Pharmaceutical Council.” Full

Medication Access Framework Identifies Social Determinants of Health (3/19, Jennifer Nessel, Pharmacy Times) reports “...‘Access to medications is an important part of high-quality, value-based healthcare,’ said Matthew Pickering, PharmD, senior director of Research and Quality Strategies at PQA, in a prepared statement. ‘Improving access, which affects adherence and patient outcomes, requires a focus on the social determinants of health. The framework we have developed holistically defines medication access and identifies gaps in quality measurement that could address the financial and nonfinancial factors that stand between patients and the medications they need.’” Full

Creating a New Way to Implement VBID Principles in Exchange Health Plans (3/18, Laura Joszt, The American Journal of Managed Care) reports “...At the University of Michigan V-BID Center's V-BID Summit, panelists who were involved with designing a market-qualified health plan that implemented VBID proposals discussed the process of coming up with the plan, which they called VBID X. ‘VBID X was really about applying the principles of value-based insurance design to the exchange marketplace,’ said Greg Gierer, the senior vice president for policy at America's Health Insurance Plans. ‘AHIP has been an early and enthusiastic supporter of VBID’; however, while VBID has been implemented in Medicare, the exchange market is different and more unique than other markets, he added.” Full

Survey: Payers, Providers Struggling with Disruptions, Value-Based Care (3/18, Jacqueline Renfrow, Fierce Healthcare) reports “...[W]hy is the industry stalling on VBC? Respondents cited limitations on data sharing, no agreement on outcome measures and lack of incentives to force payers and providers to work together. The respondents said that payers need to work more effectively with providers to facilitate high-value care. Payers should do this through standardized quality and outcomes measures, almost 30%, and developing payer-provider risk management programs, 22.6%. And sharing performance data came up as the third most important step at 13.9%.” Full

Press Releases

ICER Appoints New Members to Each of Its Three Independent Evidence Appraisal Councils (3/18, ICER Press Release) “...‘Weighing the value of a medical intervention is a multi-faceted process, spanning comparative clinical effectiveness, long-term cost-effectiveness, as well as broader contextual considerations that are harder to quantify,’ noted Steven D. Pearson, MD, MSc, President of ICER. ‘Our independent evidence appraisal councils play a vital role in ICER's work, representing an open, transparent forum to receive input from patients, clinical experts, and other stakeholders, and then to deliberate and vote on the evidence regarding a treatment's net health benefit and economic value for patients and the health system.’” Full

Annals of Internal Medicine Validates ECRI Institute's Standards for Trustworthy Clinical Guidelines (3/19, ECRI Institute Press Release) “One of the most widely cited and influential medical journals in the world highlights the standards used by ECRI Institute to assess the trustworthiness of clinical practice guidelines. In an article posted online today, Annals of Internal Medicine delivers a peer-reviewed manuscript describing how ECRI Institute developed and tested the NGC Extent of Adherence to Trustworthy Standards instrument. NEATS enables ECRI Institute to verify how guidelines stack up to the Institute of Medicine's 2011 standards for trustworthy guidelines.” Full

Journals

Comparative Effectiveness of Different Contemporary Drug-Eluting Stents in Routine Clinical Practice: A Multigroup Propensity Score Analysis Using Data from the Stent-Specific, Multicenter, Prospective Registries Kwon O, et al. March 13, 2019, Coronary Artery Disease PubMed

Comparative Effectiveness of Endovascular Thrombectomy in Elderly Stroke Patients Ajay Malhotra, et al. March 14, 2019, Stroke Stroke

Comparative Efficacy of Therapies for Treatment of Depression for Patients Undergoing Maintenance Hemodialysis: A Randomized Clinical Trial Rajnish Mehrotra, MD, MS, et al. March 19, 2019, Annals of Internal Medicine Annals of Internal Medicine

Developing and Testing the Agency for Healthcare Research and Quality's National Guideline Clearinghouse Extent of Adherence to Trustworthy Standards (NEATS) Instrument J. Jane Jue, MD, MSc, et al. March 19, 2019, Annals of Internal Medicine Annals of Internal Medicine

Articles

Is There Evidence in Real-World Evidence? (3/15, Partha S. Anbil, PharmExec) comments “...RWE has not, thus far, had a huge visible impact on drug formulary positioning, pricing, or uptake, but it is increasingly becoming, by necessity, the battleground for pharmaceutical firms operating in highly competitive therapy areas such as diabetes. RWE can help improve clinical practice and lead to more collaborative relationships with providers and other stakeholders and sits at the heart of payer-pharma outcomes-based reimbursement deals. RWE can also help pharma's internal R&D productivity, by informing more efficient clinical trial design and recruitment, for example.” Full

CDER Looks Ahead at Real World Evidence (3/15, Zachary Brennan, Regulatory Focus) reports “...The [FDA’s] Center for Drug Evaluation and Research on Friday held a webinar reviewing the agency's real-world evidence framework, which deals primarily in the postmarket space for drugs and biologics...Jacqueline Corrigan-Curay, director of the Office of Medical Policy within CDER, explained the wide spectrum of real-world data – from supplementing traditional randomized, controlled trials, or single-arm studies with historical controls, or the use of observational studies, with a registry or retrospective analysis of data.” Full

Change Healthcare's Annual Survey Points to Challenges for Value-Based Contracts (3/18, Kelly Davio, The American Journal of Managed Care) reports “Value-based contracts are not yet seeing marked success, according to the results of Change Healthcare's Ninth Annual Industry Pulse Survey...According to the survey results, 39.8% of respondents said that the majority of value-based relationships within the healthcare market will not contain both upside and downside shared risk for another 3 to 5 years. Further respondents (17.5%) said it would take more than 5 years, while still others (6.3%) said that such contracts may never become a reality.” Full

The Outcomes-Based Reimbursement Environment (3/16, Tara Herington, Pharmaceutical Commerce) reports “...As more risk-sharing contracs are adopted, the pharma industry has greater ownership for the outcomes patients achieve when taking their therapies. As a result, pharma companies are looking beyond the first prescription fill and asking how they can help patients strictly adhere to therapies, and how they can support patients in reaching both short-term and long-term clinical outcomes.” Full

Clinical Outcomes Compared With Generics, Brand-Name Drugs for Chronic Conditions (3/15, Steve Duffy, Monthly Prescribing Reference) reports "An analysis of data from over 3.5 million patients found comparable clinical outcomes among patients who initiated generics vs those who were treated with brand-name drugs for chronic conditions such as diabetes, hypertension, osteoporosis, depression and anxiety...[The authors] concluded that ‘these results could help in promoting educational interventions aimed at increasing patient and provider confidence in the ability of generic medicines to manage chronic diseases.’" Full

UK: NICE Wants to Stop Saying ‘No' – but Needs Pharma's Co-Operation (3/18, Andrew McConaghie, PMLiVE) reports “...Speaking at the international pharma conference eyeforpharma Barcelona last week, NICE's chief executive Sir Andrew Dillon struck a conciliatory note with his audience, making it clear he understood the sector's need to provide shareholders with a return on investment on novel medicines. However, he cautioned that industry, healthcare payers and health technology assessment authorities like NICE needed to do more to achieve ‘alignment' on value, evidence and price for the sake of patients.” Full

Press Releases

ICER Publishes Revised Protocol for Assessing Unsupported Price Increases for Prescription Drugs (3/15, ICER Press Release) “The Institute for Clinical and Economic Review today posted its revised protocol for conducting a new annual analysis to determine whether or not significant prescription drug price increases have been accompanied by new clinical evidence that could potentially support those increases. ICER's first ‘Unsupported Price Increase’ report is scheduled to be released on October 8, 2019.” Full

Big Data Adds Clarity, Certainty to Clinical Trial Outcomes for AFib (3/15, Mayo Clinic News Release) “...‘Clinical trials are the gold standard for evaluating treatment effects, but they have limitations such as strict eligibility criteria, small sample sizes, and cross over between treatment arms,’ notes Dr. Yao. ‘Using observational data, we hope to provide complementary evidence to help clinicians apply the findings to their everyday practice.’” Full

Journals

Impact of Health Technology Assessment and Managed Entry Schemes on Reimbursement Decisions of Centrally Authorised Medicinal Products in Belgium Van Wilder P, Pirson M, Dupont A. March 15, 2019, European Journal of Clinical Pharmacology PubMed

Reports

9th Annual Industry Pulse Report March 2019 Change Healthcare

Unsupported Price Increase Assessment: Revised Protocol March 15, 2019 ICER

Articles

Pharmalittle: A Debate over Using List Prices in Research; FDA Fast-Tracks a Purdue Opioid Overdose Drug (3/15, Ed Silverman, STAT Plus) reports “...A debate over the use of list prices to gauge the rising cost of medicines broke out in the Health Affairs blog. Robert DuBois of the National Pharmaceutical Council criticized a recent paper by arguing that "the use of list price leads to misleading results" because these do not reflect rebates paid by drug makers to win favorable insurance coverage. But the authors of that paper countered that it would be ‘problematic’ to withhold research based on list prices because uninsured and underinsured patients are exposed to list prices.” Paid Subscription Required

Patient Engagement Is Critical to Producing Useful, Relevant Research (3/14, Laura Forsythe, PhD, MPH, Kristin L. Carman, PhD, MA and David Hickam, MD, MPH, The PCORI Blog) comments “...Engagement is a key to achieving PCORI's three strategic goals—making research more patient centered, increasing the body of useful information to guide health care, and speeding the uptake and use of research findings. Our ultimate objective is to align research efforts with real-world needs, concerns and questions of patients, caregivers, clinicians, payers, and policy makers. We collected and thematically analyzed information from 126 peer-reviewed journal articles from PCORI-funded research studies that included descriptions of each research team's experiences with partner engagement.” Full

We Must Address Rising Health Care Costs With Patient-Centered Solutions (3/15, Tony Coelho, Morning Consult) comments “...The research and evidence driving the nation's health care decisions should not inherently disadvantage certain patients and people with disabilities. Policymakers should listen to their constituents who are saying that patient-centered evidence, like the research funded by PCORI, should help guide health care decision-making, rather than flawed cost-effectiveness assessments that attempt to save money but in effect put a value on one life as lesser than another.” Full

Following Medicare's ACO Program Overhaul, Most ACOs Stay—But Physician-Led ACOs Leave At A Higher Rate (3/15, William K. Bleser, et al., Health Affairs Blog) comments “...On February 12, 2019, CMS released the list of ACOs participating in the 2019 MSSP, allowing us to see who remained through the program's sixth year (2018) and to conduct early analysis of the impact of Pathways to Success on ACO participation. From these analyses, we highlight two key findings: Hospital-led ACOs and large ACOs regardless of type have low dropout rates at the end of 2018...The ACO dropout rate increased modestly at the end of 2018, in contrast to the two previous years.” Full

Press Releases

ICER Releases Draft Evidence Report on Siponimod for Treating Secondary Progressive Multiple Sclerosis (3/14, ICER Press Release) “The Institute for Clinical and Economic Review today released a Draft Evidence Report assessing the clinical effectiveness and value of siponimod (Mayzent™, Novartis) for the treatment of secondary progressive multiple sclerosis...This draft report will be open to public comment until 5pm ET on April 10, 2019. Based on stakeholder feedback, ICER may revise key assumptions and findings for its Evidence Report, which will be published on May 2, 2019.” Full

Journals

Toward a Strategy to Involve Patients in Health Technology Assessment in Spain Toledo-Chávarri A, et al. March 14, 2019, International Journal of Technology Assessment in Health Care PubMed

Reports

MS: Draft Evidence Report March 14, 2019 ICER

Articles

Access to Care: Development of a Medication Access Framework for Quality Measurement (3/14, National Pharmaceutical Council: E.V.I.dently Today) comments “...A new framework, developed by the Pharmacy Quality Alliance and supported by the National Pharmaceutical Council, identified seven main areas patients encounter while seeking access to medications and the structural, financial and personal barriers patients face within each. ‘Barriers to medication access and compliance have long been acknowledged as a serious problem for the U.S. health care system, costing billions of dollars in lost productivity, additional doctor visits, preventable hospitalizations and nursing home admissions, and even premature death. This framework provides us with actionable steps to break down those barriers to patient care,’ said Kimberly Westrich, MA, NPC Vice President of Health Services Research.” Full

On The Use Of List Prices In Drug Pricing Research (3/14, Inmaculada Hernandez and Walid Gellad, Health Affairs Blog) comments “...All too often, critics of research based on list prices seem to imply that these two data sources can solve all the problems associated with list price, but that's just not true. SSR Health has estimates for prices net of all concessions made by manufacturers, including rebates, but also coupon cards, 340B discounts, prompt pay discounts, returns provisions, and any other deduction that manufacturers include when reporting net sales. These SSR Health data are limited to branded products whose US sales are reported by publicly traded companies.” Full | Read the prior article by NPC Chief Science Officer Robert W. Dubois, MD, PhD

Novartis Strikes Kymriah Outcome-Based Deal With German Insurers (3/14, Francesca Bruce, Pink Sheet) reports “...Novartis and GWQ, a group of German health insurers, are piloting an agreement that will see the Swiss pharma firm repay some of the cost of its CAR-T cell therapy Kymriah (tisagenlecleucel) if survival outcomes are not met. It is the first outcomes-based deal for an anticancer gene therapy and CAR-T therapy in Germany, say Novartis and GWQ.” Paid Subscription Required

Value Extends Beyond the Cost of Drugs and Health Care (3/14, Jennifer Bright and Mark Linthicum, STAT) comments “...Advanced methods to tailor value assessments to subgroups are also essential for illuminating our understanding of value. Relying only on population-wide estimates of clinical- and cost-effectiveness essentially assumes that everyone responds in similar ways to therapies, and we know that isn't the case. Advanced value assessment platforms, including those our organization is building, strive to account for relevant value factors — especially patient diversity — that go beyond population averages. Such innovations are needed to enhance decision makers' abilities to deliver optimized treatments most likely to benefit patients.” Full

Diffusion Of Innovation To Improve Health Care Value: Physicians-Led Care Redesign (3/14, Pamela T. Johnson, et al., Health Affairs Blog) comments “...No silver bullet will improve access, quality, safety, and affordability of care for all patients, but an evidence-based, quality-driven approach to care redesign ensures that changes maintain, or ideally, improve patient outcomes. The [High Value Practice Academic Alliance] is designing, delivering, and disseminating a scaffolding of evidence-based practice that can safely improve affordability. And we invite the other sectors in health care to partner with us in these efforts. We know what to do. We must now transfer this knowledge into practice.” Full

Eliminating Low-Value Health Care: Where Pathways Approaches Have Succeeded (3/13, Ira Klein, MD, MBA, FACP, Journal of Clinical Pathways) comments “...The push to eliminate low-value care through use of pathways is a signal of an inflection-point in the health care ecosystem. There is too much economic and political pressure for employers not to reassess their employee health benefits design and too much scientific evidence to not utilize pathway and step approaches to eliminate low-value care. Only a few examples of models and initiatives have been illustrated above. It is not inclusive of the tremendous work being done by many in the health care quality, policy, and outcomes measurement world to bring about this needed evolution.” Full

Reducing Low-Value Care May Mean Tough Conversations With Stakeholders (3/14, Laura Joszt, The American Journal of Managed Care) reports “...The conversation has to make it clear that services are being taken away in order to keep patients safe from harm, [Gwen Darien, executive vice president for patient advocacy and engagement at the National Patient Advocate Foundation,] added. ‘A lot of the ways that we've talked about reducing low-value services has had to do with waste and waste in the system,’ Darien said. ‘People do not want to hear that anything that their doctor is prescribing for them is wasteful.’ That's why explaining the harm of unnecessary or low-value services is important and can help the patient understand that the concern is keeping them safe.” Full

Partnering on Patient-Centered Research for People with Kidney Disease (3/14, Lesa-Kaye Holtham, MPH, The PCORI Blog) comments “...The National Kidney Foundation leads the charge in increasing awareness about kidney disease through action, education, and accelerating change. A key piece of that mission is advocating and participating in research that answers the questions most important to patients with kidney disease and those who care for them. As we mark National Kidney Month, we reflect on our continued commitment to this critical patient-driven research, including our growing and meaningful relationship with PCORI.” Full

Lawmakers Hear the Down Side of Outcomes-Based Pricing (3/14, Drug Daily Bulletin) reports “...The pharmaceutical industry ‘has championed outcomes-based contracting, yet such contracts often offer illusory savings,’ said Ameet Sarpatwari, assistant director of the Harvard Medical School's Program on Regulation, Therapeutics and Law. For example, a manufacturer can promise a refund in the event a patient does not respond to a drug, but ‘price the drug such that the refund would be largely symbolic’ because it is built into the pricing structure. Outcomes-based contracts don't necessarily mean that the initial list price mirrors the drug's value, he told members of the Ways and Means health subcommittee.” Paid Subscription Required

Trump FY 2020 Budget Funds Absorption of AHRQ into NIH (3/14, Greg Slabodkin, Health Data Management) reports “...The Trump administration's FY 2020 budget is meant to streamline [HHS’] research activities and eliminate redundancies by absorbing AHRQ into NIH as the National Institute for Research on Safety and Quality...According to HHS, NIRSQ will serve as a center of excellence for improving the quality and safety of healthcare and will support the industry's transition from ‘volume’ to ‘value’ by focusing on improving outcomes, reducing cost and expanding choices for consumers.” Full

Journals

Advocating for New Patient-Centered Tools for Value-Based Treatment Choices in Oncology Jalpa A Doshi, PhD, et al. March 2019, Journal of Clinical Pathways Journal of Clinical Pathways

Efficacy of Budesonide vs Fluticasone for Initial Treatment of Eosinophilic Esophagitis in a Randomized Controlled Trial Evan S. Dellon, MD MPH, et al. March 11, 2019, Gastroenterology Gastroenterology

Instrumental Variables: The Power of Wishful Thinking vs the Confounded Reality of Comparative Effectiveness Research Soumerai SB, Koppel R March 12, 2019, Health Services Research PubMed

Reports

Access to Care: Development of a Medication Access Framework for Quality Measurement March 2019 Pharmacy Quality Alliance