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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.
Improving Patient-reported Measures in Oncology: A Call to Action
This study explores the current landscape of oncology patient-reported measures (PRMs), which are tools that capture patients’ voices related to their care experience and outcomes.
Do Patient Preferences Align with Value Frameworks? A Discrete-Choice Experiment of Patients with Breast Cancer
The study assessed patient preferences for aspects of breast-cancer treatments to evaluate the usual assumptions in scoring rubrics for value frameworks.
Underestimating the Value of an Intervention – The Case for Including Productivity in Value Assessments and Formulary Design
Research shows that including non-health care costs like productivity in value assessment frameworks can change the value assessment of interventions, impact on coverage decisions and subsequent…
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…
Current Landscape: Value Assessment Frameworks
This report analyzed seven existing U.S. value assessment frameworks, comparing and contrasting the strengths and limitations associated with each framework.
Improving Patient-reported Measures in Oncology
This is a landscape analysis of available patient-reported measures and patient-reported performance measures in oncology and offers recommendations for filling gaps in measures and removing barriers…
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,…
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…
Improving Oncology Quality Measurement in Accountable Care
This comprehensive white paper from the National Pharmaceutical Council and Discern Health identified gaps in accountable care quality measure sets for cancer, which can lead to missed opportunities…
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 encourage more…
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…
Guiding Practices for Patient-Centered Value Assessment
NPC has developed Guiding Practices for Patient-Centered Value Assessment that include 28 specific elements, which are broken out into six key aspects of value assessments: the assessment process,…