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The National Pharmaceutical Council (NPC) is a health policy research organization dedicated to the advancement of good evidence and science, and to fostering an environment in the United States that supports medical innovation.
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Showing 20 Results
Specialty drug use for autoimmune conditions varies by race and wage among employees with employer-sponsored health insurance
Published in the Journal of Managed Care and Specialty Pharmacy, this study found that low-income and non-white individuals participating in commercial health plans have lower usage of specialty…
Characterizing Health Plan Evidence Review Practices
The study finds that some plans updated the evidence in their coverage policies for specialty medicines more often than others, and the type of evidence plans cited in their coverage policies…
Health Care Spending Effectiveness: Estimates Suggest that Spending Improved U.S. Health from 1996 to 2016
This research assessed the effectiveness of U.S. health care spending by comparing changes in health outcomes and found that, overall, innovations in health care are creating more cost-effective care…
Health Care Spending Guiding Principles
NPC established a set of principles to assess health care spending estimates and policies to ensure alignment with the goals of patient-centered care.
NPC Reiterates Comments on Medicare Program; Medicare Coverage of Innovative Technology, Definition of “Reasonable and Necessary”
NPC resubmitted comments on a proposed rule to establish a Medicare coverage pathway for medical devices designated as breakthrough by the FDA.
The Dollar or Disease Burden: Caps on Healthcare Spending May Save Money, but at What “Cost” to Patients?
This study assessed the potential effects of budget caps design on disease burden and cost savings to help budget decision makers understand which budget cap features minimize impact to patient…
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.
NPC Comments on Medicare Program; Medicare Coverage of Innovative Technology, Definition of “Reasonable and Necessary”
NPC submitted comments on a proposed rule to establish a Medicare coverage pathway for medical devices designated as breakthrough by the FDA.
Are Value-based Arrangements the Answer We’ve Been Waiting for?
This NPC study explored the use of value-based arrangements as a mechanism for cost containment in the United States, noting the strengths and limitations of these tools.
U.S. Care Pathways: Continued Focus on Oncology and Outstanding Challenges
A peer-reviewed study assessed changes in development, implementation, and evaluation of care pathways, and reviewed the latest evidence on integration of pathways with value-based care initiatives…
What's Been the Bang for the Buck? Cost-Effectiveness of Health Care Spending Across Selected Conditions in the US
This study was designed to assess whether increased medical intervention spending on prevalent chronic conditions has been a good investment over time.
Are Payers Ready to Address the Financial Challenges Associated with Gene Therapy?
NPC and the Analysis Group conducted market research to explore payer views of the potential roles that existing and new alternative payment approaches could play in managing the financial risk and…
Concerns Around Budget Impact Thresholds: Not All Drugs Are The Same
A study published in Value in Health explores the potential impact of using budget thresholds as budget caps (e.g., cannot spend more than a set dollar amount) for individual drugs.
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…
Designing Successful Bundled Payment Initiatives
The National Pharmaceutical Council led a study that identified three principles intended to maximize the positive aspects and minimize the negative consequences of bundled payments.
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…
Care Pathways in U.S. Health Care Settings: Current Successes and Limitations, and Future Challenges
Care pathways, also known as clinical pathways or integrated care pathways, are typically characterized as a method for managing patient care based on clinical practice guidelines, with the main…