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Commercial coverage of specialty drugs, 2017–2021
New study examines the role of NIH and industry in bringing new treatments into clinical settings.
Stakeholder perception of pharmaceutical value: A multicriteria decision analysis pilot case study for value assessment in the United States
Study shows the impact of a more holistic approach to assessing value and how it can help address gaps within conventional value assessment.
Predictors of Adherence to Oral Anticancer Medications: An Analysis of 2010-2018 U.S. Nationwide Claims
Low-income Medicare patients who face high out-of-pocket costs are less likely to remain adherent to oral anticancer medications. This research shows the need for strategies to address adherence and…
Premium Impact of Expanding Pre-Deductible Coverage to Chronic Disease Management Medications in HSA-Eligible Health Plans
An NPC-funded study found the impact on premiums of expanding pre-deductible coverage to 116 drug classes related to chronic disease management medications in HSA-eligible health plans is small …
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…
The Impact of Expanding Pre-Deductible Coverage in HSA-Eligible Health Plans on Premiums
Research found that expanding pre-deductible coverage under employer-led health plans would add few costs to health insurance premiums, while lowering costs for patients.
Cost-Sharing and Adherence, Clinical Outcomes, Health Care Utilization, and Costs: A Systematic Literature Review
Higher patient cost-sharing for prescription medications leads to worse medication initiation, adherence, persistence, and discontinuation, according to a new systematic literature review by…
High-Deductible Health Plans: Good Practices for Employers
Research highlights good practices for designing high-deductible health plans to help enrollees better maximize the value of their benefits.
Better Value, Smarter Deductibles in HSA-HDHPs: Improving Health, Equity & Engagement
NPC and National Alliance of Healthcare Purchaser Coalitions collaborated on an Action Brief highlighting key steps employers can take to enhance their health benefit design approach.
Employer Uptake of Pre-Deductible Coverage for Preventive Services in HSA-Eligible Health Plans
An NPC-funded study shows many large employers have expanded pre-deductible coverage for medications and health services used to prevent exacerbations of common chronic conditions and would like to…
NPC Reiterates Comments on Medicare Program; Medicare Coverage of Innovative Technology, Definition of “Reasonable and Necessary”
NPC resubmitted comments on a proposed rule to establish a Medicare coverage pathway for medical devices designated as breakthrough by the FDA.
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.
NPC Comments on Medicare Program; Medicare Coverage of Innovative Technology, Definition of “Reasonable and Necessary”
NPC submitted comments on a proposed rule to establish a Medicare coverage pathway for medical devices designated as breakthrough by the FDA.
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…
Are Value-based Arrangements the Answer We’ve Been Waiting for?
This NPC study explored the use of value-based arrangements as a mechanism for cost containment in the United States, noting the strengths and limitations of these tools.
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.
Uptake and Federal Budgetary Impact of Allowing Health Savings Account-eligible High Deductible Health Plans to Cover Chronic Disease Drugs and Services Pre-deductible
This report examines the net federal budgetary impact allowing Health Savings Account-eligible HDHPs to expand pre-deductible coverage to include chronic disease services.