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 51 Results
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…
Health Spending for Commercial Plans Is Predominantly Concentrated In Small Population of High-Intensity Consumers
NPC study finds spending on prescription drugs mirrors spending on other health care services, with a small subset of the sickest patients driving the majority of spending.
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.
Assessing Consumer and Employer Willingness to Pay for New Medical Technologies
This study examines whether health care consumers and large employers would be willing to continue to pay for new medical technologies associated with significant improvements in patient health…
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.
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…
U.S. Care Pathways: Continued Focus on Oncology and Outstanding Challenges
A peer-reviewed study assessed changes in development, implementation, and evaluation of care pathways, and reviewed the latest evidence on integration of pathways with value-based care initiatives…
What's Been the Bang for the Buck? Cost-Effectiveness of Health Care Spending Across Selected Conditions in the US
This study was designed to assess whether increased medical intervention spending on prevalent chronic conditions has been a good investment over time.
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…
Are Payers Ready to Address the Financial Challenges Associated with Gene Therapy?
NPC and the Analysis Group conducted market research to explore payer views of the potential roles that existing and new alternative payment approaches could play in managing the financial risk and…
The Effect of Medical Technology Innovations on Patient Outcomes, 1990-2015: Results of a Physician Survey
A survey published in the Journal of Managed Care & Specialty Pharmacy of U.S. physicians provides insight on their perceptions regarding which medical innovation has impacted outcomes the most…
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,…
Insurance Switching and the Mismatch Between the Costs and Benefits of New Technologies
The peer-reviewed study examined the disconnect between the short-term budget impact of a treatment and its downstream effects on payers and society.
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…
Concerns Around Budget Impact Thresholds: Not All Drugs Are The Same
A study published in Value in Health explores the potential impact of using budget thresholds as budget caps (e.g., cannot spend more than a set dollar amount) for individual drugs.
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…