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 34 Results
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.
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…
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…
Assessing Value: Promise and Pitfalls Conference Summary Report
At NPC's conference, Assessing Value: Promise and Pitfalls, top experts in their fields united to discuss value assessment as it impacts payers, patients, providers and pharmaceutical innovators.
Guiding Practices for Patient-Centered Value Assessment
In 2016, NP developed Guiding Practices for Patient-Centered Value Assessment that included 28 specific elements, which are broken out into six key aspects of value assessments: the assessment…
Improving the Efficiency and Quality of the Value Assessment Process for Companion Diagnostic Tests: The Companion Test Assessment Tool
This peer-reviewed study examined some of the barriers to incorporating a Companion Diagnostic Test (CDT) into drug treatment decisions and outlined a framework to assist managed care…
Pharmaceutical Technology Assessment: Perspectives From Payers
The processes and evidence used in making pharmaceutical coverage decisions vary substantially among US health plan payers. These variations during the pharmaceutical technology assessment (PTA)…
Your Pharmacy Benefit: Make it Work for You!
The 16-page booklet offers advice for those with prescription drug coverage through an employer, union, or other group plans. Topics include Choose Your Plan, Use Your Plan, and More Options.