Showing 18 Results
Commercial coverage of specialty drugs, 2017–2021
New study examines the role of NIH and industry in bringing new treatments into clinical settings.
Characterizing Health Plan Evidence Review Practices
The study finds that some plans updated the evidence in their coverage policies for specialty medicines more often than others, and the type of evidence plans cited in their coverage policies…
Health Care Spending Effectiveness: Estimates Suggest that Spending Improved U.S. Health from 1996 to 2016
This research assessed the effectiveness of U.S. health care spending by comparing changes in health outcomes and found that, overall, innovations in health care are creating more cost-effective care…
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.
Patient-Centered Guiding Principles for Evaluating Health Care Spending
NPC established these principles to serve as a checklist to assess whether methods used for estimating health care spending are appropriate.
Patient-Centered Guiding Principles for Reforming Health Care to Address Rising Health Care Spending
NPC established these principles to assess health care spending policies to ensure alignment with the goals of patient-centered care.
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.
It Is Not Just the Prices! The Role of Chronic Disease in Accounting for Higher Health Care Spending in the United States
A new NPC study shows that the higher prevalence of chronic disease in the U.S. is a significant contributing factor to high U.S. health care spending.
Do Investments in the Social Determinants of Health Reduce Health Care Costs?
This study found that most studies of social need interventions were poorly designed, inadequately documented, and inconsistently presented. It recommends improving the study design quality through…
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…
Stakeholders Find Step Therapy Should Be Evidence-Based, Flexible and Transparent: Assessing Appropriateness Using a Consensus Approach
Stakeholders disagree on when step therapy is appropriate, but agree on a set of criteria about how to develop, implement, communicate, safeguard and evaluate step therapy protocols.
Reconciling the Seemingly Irreconcilable: How Much Are We Spending on Drugs?
In this study from the National Pharmaceutical Council and IQVIA, researchers developed a model to understand the underlying methodological inputs that drive the substantial variation in drug…
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.
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? 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…
Using an Electronic Medication Refill System to Improve Provider Productivity in an Accountable Care Setting
This case study highlights the critical components of Sharp Rees-Stealy Medical Group's electronic medication refill system that allows for a centralized team to manage all incoming prescription…
What Contributes Most to High Health Care Costs?
A small segment of the population—often the sickest patients—drive the majority of health care spending. This study, which examined the spending patterns for these high resource patients (HRP), found…
Resources for Medicare Beneficiaries: Using Your Medicare Drug Plan | What to Do If Your Medicine Isn’t Covered
This 12-page publication helps Medicare Part D recipients and caregivers understand some of the challenges involved in navigating the Medicare prescription drug system.