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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…
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…
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…
Chairman’s Blog: Let Data and Research Guide the Pricing and Access Policy Debate
NPC Board Chair and BMS SVP Michael Ryan reflects on the biopharmaceutical industry's role in solving global health challenges and how to address misunderstandings about what it takes to bring…
Social Determinants Interventions: Good Policy Solutions Require Good Data
In his AJMC editorial, NPC Interim President and CEO Dr. Robert Dubois says we need to address social determinants of health and improve patients’ lives through approaches based on strong data.
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.
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…
CMS Proposes Changes to Medicaid Best Price
CMS announced a proposal to lift some Medicaid best price restrictions, making it easier for commercial health insurers to enter into value-based payment arrangements with biopharmaceutical…
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,…
Experts Advise Including Productivity in Value Assessment Frameworks – When Included, It Can Make a Difference
NPC researchers sought to assess if productivity is included in VAF analyses, when included, does it change the value assessment of an intervention, and if including productivity could change health…
AMCP Partnership Forum: Optimizing Prior Authorization for Appropriate Medication Selection
Stakeholders focused on the challenges of current prior authorization and step therapy programs, approaches to improve these processes for patient care, and reviewed current legislative activities…
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…
Key Takeaways From an ISPOR Panel on Creative Financing Proposals
An expert panel was convened at the ISPOR 2019 annual meeting to discuss the need for novel payment approaches to address the challenges that accompany transformative therapies.
NPC in Specialty Pharmacy Times: Creative Financing for Innovative, Curative Therapies
States are getting creative about how they can meet the health care needs of their citizens, especially when it comes to curative treatments for conditions with a high rate of prevalence. More…
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…
Six Ways to Make Real-world Evidence Methods More Transparent
Acceptance of studies based on “real-world data” remains limited, partly because the research methods used to generate usable evidence are not always transparent. That perception could change thanks…
Symposium: Able to Cure, Able to Pay — Closing the Widening Gap
In Louisiana, significant prevalence of hepatitis C cases and high treatment costs has led the state to turn to an innovative idea – using a Netflix-style subscription model to pay for curative…
Patients on RWE: WIIFM? (What’s In It for Me?)
In an article published in The Patient, NPC and the National Health Council found that while most patients were initially unaware of real-world evidence (RWE) and its actual or potential uses,…