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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…
Health Care Spending Guiding Principles
NPC established a set of principles to assess health care spending estimates and policies to ensure alignment with the goals of patient-centered care.
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…
The Dollar or Disease Burden: Caps on Healthcare Spending May Save Money, but at What “Cost” to Patients?
This study assessed the potential effects of budget caps design on disease burden and cost savings to help budget decision makers understand which budget cap features minimize impact to patient…
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.
As Value Assessments Evolve, Are They Ready for Prime Time?
This peer-reviewed study examined the evolution of the value assessment landscape in the United States.
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…
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…
Why Value Framework Assessments Arrive at Different Conclusions: A Multiple Myeloma Case Study
Researchers conducted cross-framework comparisons of multiple myeloma assessments using four value assessment frameworks and examined the consistency of findings across three case studies.
Value Assessment Frameworks: Are They Up To The Challenge?
In this article published on the Health Affairs Blog, NPC researchers Dr. Robert Dubois and Kimberly Westrich ask: Are value assessment frameworks ready to compare the health and economic impacts of…