Showing 28 Results
Impact of Shared Decision-Making and Patient Decision Aids on Health Care Cost and Utilization in the US: A Systematic Review
Shared decision-making and patient decision aids may reduce costs or improve utilization but not consistently across settings and diseases, according to a new systemic literature review by…
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…
Impact of Real-Time Benefit Tools on Patients’ Access to Medications: A Retrospective Cohort Study
Study finds the use of Real-Time Prescription Benefit Tools results in higher fill rates and lower cancellation rates.
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…
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…
The Patient’s Medication Access Journey: A Conceptual Framework Focused Beyond Adherence
The Pharmacy Quality Alliance, with support from NPC, developed a framework that defines a patient’s medication access journey and characterizes barriers frequently encountered while seeking…
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.
Online Tools to Synthesize Real-World Evidence of Comparative Effectiveness Research to Enhance Formulary Decision Making
This JMCP study describes and compares the features and characteristics of five tools to evaluate real-world evidence studies and adds clarity on what the tools provide.
Improving Transparency to Build Trust in Real-World Secondary Data Studies for Hypothesis Testing—Why, What, and How Recommendations and a Roadmap from the Real-World Evidence Transparency Initiative
A position paper by the RWE Transparency Initiative describes a plan for improving the transparency of the research process and making registration of real-world evidence study methods easier and…
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…
U.S. Care Pathways: Continued Focus on Oncology and Outstanding Challenges
A peer-reviewed study assessed changes in development, implementation, and evaluation of care pathways, and reviewed the latest evidence on integration of pathways with value-based care initiatives…
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 encourage more…
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…
A Dynamic Approach to Consumer Cost-Sharing for Prescription Drugs
The level of consumer cost-sharing for higher cost medication should be aligned with the clinical value – not solely the price – when lower cost alternatives do not produce the desired patient…