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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.
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’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…
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.
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…
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.
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…
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…
Paying for Cures: Ensuring Patient Access and System Sustainability
One of the most vexing challenges facing the U.S. health care system is how payers and biopharmaceutical innovators can work together to ensure that curative treatments are more broadly accessible to…
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…
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.
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 with the…
Using an Electronic Medication Refill System to Improve Provider Productivity in an Accountable Care Setting
This case study highlights the critical components of Sharp Rees-Stealy Medical Group's electronic medication refill system that allows for a centralized team to manage all incoming prescription…