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Commercial coverage of specialty drugs, 2017–2021
New study examines the role of NIH and industry in bringing new treatments into clinical settings.
Predictors of Adherence to Oral Anticancer Medications: An Analysis of 2010-2018 U.S. Nationwide Claims
Low-income Medicare patients who face high out-of-pocket costs are less likely to remain adherent to oral anticancer medications. This research shows the need for strategies to address adherence and…
Cost-Sharing and Adherence, Clinical Outcomes, Health Care Utilization, and Costs: A Systematic Literature Review
Higher patient cost-sharing for prescription medications leads to worse medication initiation, adherence, persistence, and discontinuation, according to a new systematic literature review by…
The Impact of COVID-19 on Real-World Health Data and Research
This white paper provides key health care stakeholders, including clinicians, researchers, payers and regulators, with a broad view of how the COVID-19 pandemic may have impacted real-world data (RWD…
Stakeholders Find Step Therapy Should Be Evidence-Based, Flexible and Transparent: Assessing Appropriateness Using a Consensus Approach
Stakeholders disagree on when step therapy is appropriate, but agree on a set of criteria about how to develop, implement, communicate, safeguard and evaluate step therapy protocols.
Optimization of Medication Use at Accountable Care Organizations
This study assesses a broad range of factors related to how accountable care organizations optimize medication use and meet financial and quality metrics.
Health Plan Use of Patient Data: From the Routine to the Transformational
As the abundance and variety of patient data elements and sources continue to grow, health plans seek opportunities to deepen insights from multiple sources of patient data to shape care delivery,…
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
A study convened an expert roundtable of patient, payer, and employer representatives to review four case studies to understand when it would be more (or less) acceptable to require patients with the…
Improving Oncology Quality Measurement in Accountable Care: Filling Gaps with Cross-Cutting Measures
According to a study, gaps in the quality measures used by accountable care programs to assess cancer care may obscure problems in care delivery and lead to missed opportunities for improvement of…
The Central Role of Physician Leadership for Driving Change in Value-Based Care Environments
This case study analyzing accountable care organizations looks at lessons learned from the implementation of the American Medical Group Foundation’s Measure Up/Pressure Down initiative.
A Dynamic Approach to Consumer Cost-Sharing for Prescription Drugs
The level of consumer cost-sharing for higher cost medication should be aligned with the clinical value – not solely the price – when lower cost alternatives do not produce the desired patient…
Data, Data Everywhere, But Access Remains a Big Issue for Researchers
This study captures the policy inconsistencies and hurdles that can hinder use of publicly funded federal and state datasets for researchers. These limitations can make it harder to conduct high…
Why Is Broader Access to Publicly Funded Data Important?
This infographic illustrates the policy inconsistencies and hurdles that can hinder use of publicly funded federal and state datasets for researchers.
Using an Electronic Medication Refill System to Improve Provider Productivity in an Accountable Care Setting
This case study highlights the critical components of Sharp Rees-Stealy Medical Group's electronic medication refill system that allows for a centralized team to manage all incoming prescription…
Solutions for Filling Gaps in Accountable Care Measure Sets
This peer-reviewed study, “Solutions for Filling Gaps in Accountable Care Measure Sets,” explores measurement gaps for high-priority conditions and identifies ways to improve measure sets.
When Does FDAMA Section 114 Apply? Ten Case Studies
There is hesitation to disseminate comparative effectiveness research because of ambiguities in the law that was established to help biopharmaceutical companies engage health plans around real-world…