Resources
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 55 Results
Little Consistency in Evidence Cited by Commercial Health Plans for Specialty Drug Coverage
Evidence cited by payers in coverage decisions for specialty medicines varies significantly, with health plans only citing the same study in 15% of health plan coverage policies for a given drug and…
Patient-Community Perspectives on Real-World Evidence: Enhancing Engagement, Understanding, and Trust
Researchers found that while most patient organizations were initially unaware of real-world evidence (RWE) and its actual or potential uses, they recognized the ability of RWE to provide relevant…
Prioritizing Health Care Spending: Engaging Employees in Health Care Benefit Design
A case study shows that employees who are who are meaningfully engaged in deliberating and designing their health care benefits may have a more positive view of their coverage options.
Study of U.S. Commercial Health Plans Shows Widespread Variation in Coverage and Reimbursement for Specialty Medicines
Research published in Health Affairs shows that insurance coverage and reimbursement for specialty medications varies substantially, finding that only 15.9% of drug coverage policies were consistent…
Financial Impact of HSA-HDHP Reform to Improve Access to Chronic Disease Management Medications
According to an issue brief from VBID Health, providing pre-deductible coverage for medicines used to treat common chronic conditions could lower out-of-pocket costs and increase medication adherence…
A Comparison of Coverage Restrictions for Biopharmaceuticals and Medical Procedures
Payer evaluation and coverage of pharmaceuticals and medical procedures may differ independent of their clinical benefit. Therapy access depends on factor other than cost and clinical benefit,…
Peer-reviewed Journal Editors' Views on Real-world Evidence
A study published in the International Journal of Technology Assessment in Health Care reveals that real-world evidence is considered valuable by the editors of peer-reviewed journals—if it meets…
Toward Better Value
There is a disconnect between the important role employers believe their pharmacy benefit managers (PBMs) play in helping to manage prescription drug benefits and employers’ perceptions of the…
Real-World Evidence: Useful in the Real World of United States Payer Decision-Making? How? When? And What Studies?
Research published in Value in Health on real-world evidence provides a deeper understanding of when and how managed care organizations use RWE in decision-making, and how to increase its use.
Information Wanted: Finding the Balance in Pharmaceutical Evidence Exchange With Payers and Providers
Payers and providers were surveyed to understand the type of health care economic information (HCEI) they desire and value in the current and future health care environment, as well as the potential…
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,…
Is Real World Evidence Used in P&T Monographs and Therapeutic Class Reviews?
Payers infrequently used real-world evidence (RWE), or information on how treatments work in the real world, to guide their medication coverage and reimbursement decisions, according to research…
Does a One Size Fits All Cost-Sharing Approach Incentivize Appropriate Medication Use?
Patients contribute to health care costs through out-of-pocket expenses, like copays and coinsurance. These cost-sharing mechanisms are intended to help payers manage costs and…
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…
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…
Got CER? Educating Pharmacists for Practice in the Future: New Tools for New Challenges
This study provides an early evaluation of the CER Collaborative's training program's impact on learners’ self-reported abilities to evaluate and incorporate comparative effectiveness research…
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.