E.V.I.dently June 2020

Message from NPC

Sustainable Solutions for Patients’ Sake

COVID-19 has led many of us to take a look at the healthcare system we have – and ask hard questions about the healthcare system we need. In a new blog post, Blasine Penkowski, NPC Chair of the Board, and Chief Strategic Customer Officer at Johnson & Johnson Health Care Systems Inc., proposes some guiding principles on how we can move toward a post-COVID world and build a more resilient system where patients have the care they need. Read the full post on NPC’s website.

NPC Now: A Look at Our Latest Work

Ready, Fire, Aim: How Not to Approach COVID Pricing Discussions

The COVID-19 pandemic has placed a positive spotlight on the importance of biopharmaceutical innovation, but it also has sparked conversations about health spending and value. Recently, Chief Science Officer Robert Dubois took the Institute for Clinical and Economic Review (ICER) to task for their rushed report on how to price COVID-19 treatments, offering a staunch counterpoint in the Health Affairs Blog. This week ICER released an updated report, which differs greatly from the first in its new pricing estimate. NPC expressed its concerns about ICER’s updated report in a new blog post, “Ready, Fire, Aim: How Not to Approach COVID-19 Pricing Discussions.” In addition, to continue the conversation on this important issue, NPC will host a webinar on July 14 on COVID-19 pricing with a lineup of experts who have recently written articles on COVID-19 pricing decisions. We invite you to attend this discussion. Registration is available on NPC’s website.

NPC Releases 2019 Annual Report

NPC published its 2019 Annual Report, a summary of our continuing efforts to produce evidence-based research and engage in important conversations about health care’s greatest challenges. In a very busy and productive year, NPC continued to be a leading voice in health care policy research on real-world evidence, value assessment, access to care, and innovation in health delivery.

A Format to Removing Barriers to Health Care

NPC and its research partners provided a commentary on the evolution of the AMCP Format for Formulary Submissions in the June issue of the Journal of Managed Care & Specialty Pharmacy's 25th anniversary series. The Format has an important role to play amidst the current COVID-19 pandemic by addressing the need to remove barriers to health care and ensuring efficient decision-making and coverage for patients. The article looks at how the exchange of information has changed alongside the sophistication of products, as well as the ways health care is organized, delivered and reimbursed.

Do Patient Preferences Align with Value Frameworks?

A study by researchers from NPC, Temple University College of Public Health and Duke University School of Medicine, published in the journal Medical Decision Making Policy and Practice, assessed patient preferences for aspects of breast-cancer treatments to evaluate and inform the usual assumptions in scoring rubrics for value frameworks. The goal was to test an assumption in most-commonly used oncology value frameworks – homogeneity of patient values for treatment outcomes – and to find out whether the assumption is adequate in terms of disease stage and background. Check out our summary of the research on the NPC website.

Other Research and Info

Medicaid Best Prices Change Proposal

Paying for prescription medicines based on their value to patients is increasingly seen as a promising technique to combat rising medication costs, but federal regulations have hampered the broader use of value-based arrangements. That could change under a proposal announced by the Centers for Medicare and Medicaid Services (CMS) to lift some Medicaid Best Price restrictions, making it easier for commercial health insurers to enter into value-based payment arrangements with biopharmaceutical manufacturers. NPC is continuing to review the proposal and plans to submit comments to CMS. Learn more about the proposed changes for Medicaid Best Price on our blog.

PQA and NPC Fund Two Research Projects to Address Medication Access Barriers

The Pharmacy Quality Alliance (PQA) and NPC announced two research grants to address barriers patients face in accessing needed medications. Researchers at The Johns Hopkins Hospital and the University of Rhode Island have each received a grant to study patients’ real-world medication access problems. The projects will leverage the recent PQA and NPC framework that defines the patient journey to medication access and identifies quality measurement gaps that could address the financial and non-financial factors that stand between patients and the medications they need.

NPC Submits Comments to National Quality Forum on Patient-Reported Outcomes

NPC submitted comments to the National Quality Forum (NQF) on its Patient-Reported Outcomes Draft Recommendations Report. The comments draw on the 2019 NPC/Discern Health report Improving Patient-reported Measures in Oncology, highlighting areas of agreement and opportunities for additional alignment in NQF’s draft recommendations report.

ICYMI: Articles of Note

  • Hamilton Lopez M, Daniel GW, Fiore NC, Higgins A, and McClellan MB. Paying For Value From Costly Medical Technologies: A Framework For Applying Value-Based Payment Reforms, June 2020, Health Affairs

  • Yuan X et al. Value-Based Insurance Design in Louisiana: Blue Cross Blue Shield's Zero Dollar Co-Pay Program, June 11, 2020, The American Journal of Managed Care

Events and Education

Webinar: It's Time to Talk About COVID-19 Prices

A treatment for COVID-19, when found, will bring a lot of value to society – but what price are we prepared to pay for this value? How do we make sure innovation in medicine continues to grow after this pandemic is over? And what incentives should society offer for current and future work in keeping us safe? Join NPC’s Dr. Dubois on Tuesday, July 14 at 3:30 pm for a lively discussion with experts who have recently written articles addressing these questions, including Peter Bach, Director, Center for Health Policy and Outcomes, Memorial Sloan Kettering Cancer Center; Craig Garthwaite, Research Professor in Hospital and Health Services, Director, Program on Healthcare, Northwestern University; Peter Neumann, Director, Center for the Evaluation of Value and Risk in Health, Professor of Medicine, Tufts University School of Medicine; and Sarah K. Emond, Executive Vice President and Chief Operating Officer, ICER. Registration is available on NPC’s website.