Patients who have the same condition sometimes pay different out-of-pocket costs for their medications, but when is this differential more appropriate? On Tuesday, July 18, the National Pharmaceutical Council (NPC) tackled this dilemma in the online webinar, “Same Condition, Different Costs: Should Patients Pay Different Amounts?”
This program, moderated by NPC Vice President of Comparative Effectiveness Research Jennifer Graff, PharmD, featured a discussion on the five guiding principles, based on recent NPC research, for when it is less acceptable for patients with the same condition to have different costs.
- Mark Fendrick, MD: Professor, Departments of Internal Medicine & Health Management & Policy, Director, Center for Value-Based Insurance Design, University of Michigan
- Jennifer Graff, PharmD (Moderator): Vice President, Comparative Effectiveness Research; National Pharmaceutical Council
- Cheryl Larson: Vice President, Midwest Business Group on Health
- Helen Sherman, PharmD: Vice President, Solid Benefit Guidance
NPC explored variable cost-sharing in a research study published in the Journal of Managed Care & Specialty Pharmacy, “Does a One-Size-Fits-All Cost-Sharing Approach Incentivize Appropriate Medication Use? A Roundtable on the Fairness and Ethics Associated with Variable Cost Sharing.” The study probes stakeholder perspectives (including health plans, employers and patients) on ethics and fairness of cost-sharing based on formulary tier rather than medical appropriateness for patients. Read the study.