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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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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: how often, how different, and how comprehensive?
All health care decisions should be evidence-based. Until now, it has been relatively unclear what goes into health plan evidence reviews. How frequently do health plans update their specialty drug…
Achieving “Fair Access” Requires Better Benefit Design
An Institute for Clinical and Economic Review report acknowledges that patients are still facing barriers to needed treatments as a result of their health benefit design.
NPC in Health Affairs: Payment Innovation Not Keeping Up
In a Health Affairs Blog article, NPC and MIT researchers outline how a new rule from CMS may fall short of what is needed to improve patient access to durable cell and gene therapies that target…
NPC’s New Leader: Merging Research and Data with Real-World Experience
NPC Board Chair Michael Ryan says John M. O’Brien’s arrival as the new president and CEO of NPC reinforces a vital role the biopharmaceutical industry can play in the ongoing debate about health care…
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…
Chairman’s Blog: Let Data and Research Guide the Pricing and Access Policy Debate
NPC Board Chair and BMS SVP Michael Ryan reflects on the biopharmaceutical industry's role in solving global health challenges and how to address misunderstandings about what it takes to bring…
Social Determinants Interventions: Good Policy Solutions Require Good Data
In his AJMC editorial, NPC Interim President and CEO Dr. Robert Dubois says we need to address social determinants of health and improve patients’ lives through approaches based on strong data.
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.
If You Must Do Step Therapy, Do It Right
Finding consensus among health care stakeholders is never easy, and that is certainly true when it comes to the use of care management tools. But there are areas of agreement, especially if we focus…
AARDA’s Randy Rutta Talks Step Therapy
In this Q&A, Randy Rutta, AARDA’s President and CEO, talks about his organization’s efforts to raise awareness about step therapy and opportunities for patient-centered reforms.
NPC Weighs in on NQF’s Draft Report on Patient-Reported Outcomes
The National Pharmaceutical Council (NPC) submitted comments to the National Quality Forum (NQF) regarding the Patient-Reported Outcomes: Best Practices on Selection and Data Collection draft…
Lessons from COVID-19: Step Therapy Should Not Be a Barrier to Patient Access
Step therapy requires patients to try a clinically recognized, lower cost first-line therapy before receiving reimbursement for an alternative therapy prescribed by the physician and can delay access…
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.
AMCP Partnership Forum: Optimizing Prior Authorization for Appropriate Medication Selection
Stakeholders focused on the challenges of current prior authorization and step therapy programs, approaches to improve these processes for patient care, and reviewed current legislative activities…
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…
Key Takeaways From an ISPOR Panel on Creative Financing Proposals
An expert panel was convened at the ISPOR 2019 annual meeting to discuss the need for novel payment approaches to address the challenges that accompany transformative therapies.