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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.
Impact of Shared Decision-Making and Patient Decision Aids on Health Care Cost and Utilization in the US: A Systematic Review
Shared decision-making and patient decision aids may reduce costs or improve utilization but not consistently across settings and diseases, according to a new systemic literature review by…
NPC Comments on CMS's Hospital Outpatient Prospective Payment Systems Proposed Rule
NPC comments raise potential concerns as CMS states its intent to make significant changes to the payment rate for drugs purchased through the 340B program.
NPC Comments on CMS CY 2023 Payment Policies under the Physician Fee Schedule
NPC's comments offer input on CMS's implementation of the Discarded Drug Refund Policy, support continuing the add-on payment for at-home COVID-19 vaccinations, and provide recommendations on the…
NPC Comments on CMS Request for Information on the Medicare Program
NPC's comments to CMS's recent request for information on the Medicare program focus on access, innovation and the importance of patient engagement.
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…
Impact of Real-Time Benefit Tools on Patients’ Access to Medications: A Retrospective Cohort Study
Study finds the use of Real-Time Prescription Benefit Tools results in higher fill rates and lower cancellation rates.
Specialty Drug and Healthcare Utilization Vary by Wage Level in Employer-Sponsored Health Plans
This research shows that low-wage employees are less likely use autoimmune medicines than employees who earn more despite a higher prevalence of autoimmune conditions in low-wage employees. These…
Comments to FTC on Business Practices of PBMs and Their Impact on Pharmacies and Consumers
NPC submitted comments to the Federal Trade Commission encouraging the study of anti-competitive business practices of pharmacy benefit managers and their impact on drug affordability and access.
NPC Comments on HHS Notice of Benefit and Payment Parameters for 2023
NPC offers research-based comments to improve patient access to care and health equity.
The Patient’s Medication Access Journey: A Conceptual Framework Focused Beyond Adherence
The Pharmacy Quality Alliance, with support from NPC, developed a framework that defines a patient’s medication access journey and characterizes barriers frequently encountered while seeking…
Limited Role of Patient Input in Specialty Drug Coverage Policies
A new study in JMCP found that patient input is rarely sought for coverage policies – although plans had processes to engage physicians and medical societies when developing coverage policies, no…
Affordability Is About More Than Drug Prices
A research survey from NPC and Xcenda found that potential government involvement in drug pricing would be unlikely to increase patient affordability.
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.
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…
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…