Resources
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 43 Results
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.
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…
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…
Limited Role of Patient Input in Specialty Drug Coverage Policies
A new study in JMCP found that patient input is rarely sought for coverage policies – although plans had processes to engage physicians and medical societies when developing coverage policies, no…
Affordability Is About More Than Drug Prices
A research survey from NPC and Xcenda found that potential government involvement in drug pricing would be unlikely to increase patient affordability.
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…
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.
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…
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…
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…
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…
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…
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), …