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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…
Achieving “Fair Access” Requires Better Benefit Design
An Institute for Clinical and Economic Review report acknowledges that patients are still facing barriers to needed treatments as a result of their health benefit design.
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…
Avoiding Methodological Faults in Real-World Evidence
Researchers from Brigham and Women’s Hospital, Harvard Medical Center and NPC found that the potential for biased findings in RWE studies increases substantially in the absence of a rigorous and…
NPC’s New Leader: Merging Research and Data with Real-World Experience
NPC Board Chair Michael Ryan says John M. O’Brien’s arrival as the new president and CEO of NPC reinforces a vital role the biopharmaceutical industry can play in the ongoing debate about health care…
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 Addressing…
If You Must Do Step Therapy, Do It Right
Finding consensus among health care stakeholders is never easy, and that is certainly true when it comes to the use of care management tools. But there are areas of agreement, especially if we focus…
What’s In Your RWE Evaluation Toolbox?
Real-world evidence (RWE) – information collected from everyday health care experiences – is growing in availability, and many health care decision-makers are interested in understanding and using…
Online Tools to Synthesize Real-World Evidence of Comparative Effectiveness Research to Enhance Formulary Decision Making
The authors describe and compare the features and characteristics of five tools to evaluate real-world evidence studies and add clarity on what the tools provide.
Empowering the Patient Voice in Value Assessment: Paving the Way for MCDA
The National Health Council (NHC) and National Pharmaceutical Council (NPC) co-hosted a webinar that explored how multi-criteria decision-making analysis (MCDA) can be used in value assessment.
Multi-Criteria Decision Analysis: A Way to Put Patient Concerns Front and Center in Value Assessment?
NHC and NPC released a white paper outlining multi-criteria decision analysis (MCDA), an approach to value assessment that may more holistically address patients’ concerns, experiences and treatment…
AARDA’s Randy Rutta Talks Step Therapy
In this Q&A, Randy Rutta, AARDA’s President and CEO, talks about his organization’s efforts to raise awareness about step therapy and opportunities for patient-centered reforms.
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…
Lessons from COVID-19: Step Therapy Should Not Be a Barrier to Patient Access
Step therapy requires patients to try a clinically recognized, lower cost first-line therapy before receiving reimbursement for an alternative therapy prescribed by the physician and can delay access…
Ready, Fire, Aim: How Not to Approach COVID Pricing Discussions
NPC raises concerns about various approaches to considering pricing for COVID-19 treatments.
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?
A study by NPC suggests that while value-based arrangements can be one of many tools that payers leverage to address rising costs, it is also important to recognize the strengths and limitations…
New Study Reveals Little Consistency in Evidence Cited by Commercial Health Plans for Specialty Drug Coverage
When the health care community talks about evidence-based medicine, it’s usually in the context of efforts to ensure clinicians are delivering treatments to patients that align with the best…
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…