Patients who have the same condition sometimes pay different out-of-pocket costs for their medications, but when is this differential more appropriate? The National Pharmaceutical Council (NPC) tackled this dilemma in our webinar, “Same Condition, Different Costs: Should Patients Pay Different Amounts?” held on Tuesday, July 18, 2017.
This program, moderated by NPC Vice President of Comparative Effectiveness Research Jennifer Graff, PharmD, featured a discussion on the five guiding principles, based on recent NPC research, for when it is less acceptable for patients with the same condition to have different costs. Audience members had the opportunity to engage in a question-and-answer session with a stakeholder reactor panel that addressed the salient and sometimes difficult realities associated with cost-sharing models.
NPC explored variable cost-sharing in a research study published in the Journal of Managed Care & Specialty Pharmacy, “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.” The study probed stakeholder perspectives (including health plans, employers and patients) on ethics and fairness of cost-sharing based on formulary tier rather than medical appropriateness for patients.
- Mark Fendrick, MD: Professor, Departments of Internal Medicine & Health Management & Policy, Director, Center for Value-Based Insurance Design, University of Michigan
- Jennifer Graff, PharmD (Moderator): Vice President, Comparative Effectiveness Research; National Pharmaceutical Council
- Cheryl Larson: Vice President, Midwest Business Group on Health
- Helen Sherman, PharmD: Vice President, Solid Benefit Guidance