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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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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…
Kimberly Westrich Talks Benefit Design with AJMC
NPC's Vice President of Health Services Research, Kimberly Westrich, MA, discusses how the healthcare system can incentivize high-value care.
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…
Walking the Walk: Taking Needed Steps to Reduce Low-Value Care
Three leading researchers detail steps to reduce low-value care in the latest edition of The American Journal of Managed Care. Their approach complements a similar effort, the Roadmap for…
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.
Racial and Socioeconomic Disparities: Ignoring Inequitable Benefit Design Is Not an Option
In a new commentary published in BenefitsPro, Kimberly Westrich, NPC Vice President for Health Services Research, and Bruce Sherman, MD, medical advisor for the National Alliance of Healthcare…
How Can Payers Advance Patient-reported Measures in Oncology, and Why Should We Care?
A peer-reviewed study describes the current state of patient-reported measures and patient-reported performance measures in oncology, the barriers to implementation, and actionable recommendations…
Addressing Low-Value Care in the Time of COVID-19
The COVID-19 pandemic has had an enormous economic impact that is being felt across our communities, businesses and the overall health care system. It has placed a larger spotlight on the challenges…
NPC Comments on CMS Best Price and Barriers to Value-Based Arrangements
NPC outlines how Medicaid Best Price poses a barrier to implementing value-based arrangements and hinders innovation in payment and delivery systems, which can make it difficult for patients to…
Evolution of the AMCP Format for Formulary Submissions: Yesterday, Today and Tomorrow
The ongoing development of vaccines and treatments for COVID-19 is raising hopes as the world awaits the return to a normal way of life. But as seen in the past decades in the fight against cancer,…
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.
NPC in Specialty Pharmacy Times: Creative Financing for Innovative, Curative Therapies
States are getting creative about how they can meet the health care needs of their citizens, especially when it comes to curative treatments for conditions with a high rate of prevalence. More…
AMCP Opens Comment Period for Updating Format for Manufacturer-Payor Communications
As part of its ongoing efforts to align with new federal guidance, the Academy of Managed Care Pharmacy released an updated draft of its Format for Formulary Submissions for public comment. Read more…
Symposium: Able to Cure, Able to Pay — Closing the Widening Gap
In Louisiana, significant prevalence of hepatitis C cases and high treatment costs has led the state to turn to an innovative idea – using a Netflix-style subscription model to pay for curative…
Paying for Cures: Ensuring Patient Access and System Sustainability
One of the most vexing challenges facing the U.S. health care system is how payers and biopharmaceutical innovators can work together to ensure that curative treatments are more broadly accessible to…