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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 48 Results
The Impact of COVID-19 on Real-World Health Data and Research
This white paper provides key health care stakeholders, including clinicians, researchers, payers and regulators, with a broad view of how the COVID-19 pandemic may have impacted real-world data (RWD…
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.
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.
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.
Little Consistency in Evidence Cited by Commercial Health Plans for Specialty Drug Coverage
Evidence cited by payers in coverage decisions for specialty medicines varies significantly, with health plans only citing the same study in 15% of health plan coverage policies for a given drug and…
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.
Value-Based Agreements May Be More Prevalent Than Assumed
Research published in AJMC shows that value-based agreements (VBAs) between U.S. payers and biopharmaceutical manufacturers may be more prevalent than originally thought.
Prioritizing Health Care Spending: Engaging Employees in Health Care Benefit Design
A case study shows that employees who are who are meaningfully engaged in deliberating and designing their health care benefits may have a more positive view of their coverage options.
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…
Are Payers Ready to Address the Financial Challenges Associated with Gene Therapy?
NPC and the Analysis Group conducted market research to explore payer views of the potential roles that existing and new alternative payment approaches could play in managing the financial risk and…
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…
Regulatory Barriers Impair Alignment of Biopharmaceutical Price and Value
This white paper highlights the challenges biopharmaceutical manufacturers and payers face when developing value-based contracts.
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…
Health Plan Use of Patient Data: From the Routine to the Transformational
As the abundance and variety of patient data elements and sources continue to grow, health plans seek opportunities to deepen insights from multiple sources of patient data to shape care delivery,…
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…
Designing Successful Bundled Payment Initiatives
The National Pharmaceutical Council led a study that identified three principles intended to maximize the positive aspects and minimize the negative consequences of bundled payments.