Lessons from a Quantitative Analysis of the First Round of CMS Patient Listening Sessions for IRA’s Medicare DPNP
A new NPC publication in PharmacoEconomics – Open details learnings to help CMS improve the format and speaker representativeness of future patient-focused listening sessions.
For Immediate Release: November 11, 2024
Contact: Michael Pratt, 202-827-2088, [email protected]
Washington, D.C. – Medicare administrators held a series of patient-focused listening sessions in Fall 2023 for each of the first 10 drugs selected for the Inflation Reduction Act’s Medicare Drug Price Negotiation Program (DPNP). While the listening sessions marked an important step toward facilitating patient engagement, there was a noted lack of diversity among speakers and limited patient-centered input on evidence related to the selected drugs against the backdrop of uncertainty about how speakers’ input would contribute to the DPNP process.
A new analysis from the National Pharmaceutical Council published in PharmacoEconomics – Open, “CMS’s Drug Price Negotiation Program 2023 Patient-Focused Listening Sessions: A Descriptive Analysis of Speaker Remarks,” quantifies important details about the number and makeup of speakers and reports how long they talked about key areas of interest related to the DPNP process. The study suggests gaps in the initial process of obtaining stakeholder input and highlights suggested improvements for future iterations.
The research was authored by Julie A. Patterson, PharmD, PhD; Tyler D. Wagner, PharmD, PhD; Rayan K. Salih, PharmD; Gabri’el D. Shabazz, MPH; and Jonathan D. Campbell, PhD, MS. This quantitative, descriptive analysis examined remarks from more than 100 total speakers across 10 CMS-hosted patient-focused listening sessions.
The analysis found that:
- While speakers during the first 10 listening sessions focused their time on patient experience and evidence the most (median of 36.5% of time per speaker slot), CMS received a median of only 12.3 total minutes of evidence about selected drugs or therapeutic alternatives per listening session.
- Notably, patient access/benefit design was the second-most discussed topic (median of 12.1% of speaking time per speaker slot).
- Out of an anticipated 200 speaker slots, only 106 total speakers and 70 unique speakers participated.
- Of the 70 unique speakers, 54.2% were patients; 57.1% were female; 57.1% were below Medicare age; and 82.9% were White.
“This study sought to quantitatively show the limited window provided by the one-way communication structure with patients and their representatives in the first round of listening sessions,” said Dr. Patterson, the study’s lead author and NPC Senior Director of Research. “We applaud CMS administrators for recognizing the limitations of the passive listening format and hope that the next series of patient-focused events will prioritize two-way discourse informed by science and transparency.”
This study underscores some of the shortcomings related to the first series of patient-focused listening sessions, and in the Final Guidance for Initial Price Applicability Year 2027, CMS has indicated intent to improve the design of the next round of events scheduled for 2025.
The study recommends the format of future patient-focused listening sessions should evolve toward best practices for patient engagement:
- Future listening sessions should be structured to emphasize robust, two-way dialogue between CMS, patients, caregivers, providers, and patient advocacy organizations. Specifically, patient engagement should communicate clear goals and strive to establish a partnership and ongoing dialogue with patients, their families, and their advocates.
- In comments to CMS, patient advocacy organizations have emphasized the need for clear communication from CMS about the objectives and desired outcomes of the patient-focused events, as well as transparency surrounding how the collected evidence informs the DPNP process.
- Event logistics can be improved to facilitate patient engagement, including offering translation services, accommodations for patients with disabilities, and multi-modal outreach.
“Our hope is that this study helps CMS understand how the volume or focus of speaker remarks may each shift in future iterations of patient engagement events if there is more clarity about how that input will be used by the agency,” said Dr. Wagner, study co-author and NPC Associate Director of Research.
“Our work highlights several recommendations to facilitate increased patient engagement, and NPC is committed to conducting ongoing reviews of the patient-focused listening events,” said Dr. Campbell, NPC’s Chief Science Officer and study co-author.
More From NPC:
"HPR105 Breadth of Patient and Stakeholder Input in CMS's Drug Price Negotiation Program: A Content Analysis of the 2023 Patient-Focused Listening Sessions" | Value in Health
"Unintended Consequences of the Inflation Reduction Act: Clinical Development Toward Subsequent Indications" | The American Journal of Managed Care
About the National Pharmaceutical Council
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. Founded in 1953 and supported by the nation's major research-based pharmaceutical companies, NPC focuses on research development, information dissemination and education on the critical issues of evidence, innovation, and the value of medicines for patients. For more information, visit www.npcnow.org and follow NPC on LinkedIn.