The National Pharmaceutical Council (NPC) and Tufts Center for the Evaluation of Value and Risk in Health (CEVR) hosted a webinar, “Driving Evidence-Based Health Plan Coverage by Recognizing Gaps, Updating Practices,” that addressed how health plans use evidence to inform coverage decisions. The one-hour session featured research findings from NPC and Tufts' study, “Little Consistency in Evidence Cited by Commercial Health Plans for Specialty Drug Coverage."
The webinar covered topics such as:
- The gaps between evidence and coverage policies, and the variation across health plans in the quantity, breadth and types of clinical and economic evidence used to inform coverage policies.
- The variations in coverage for specialty medicines by U.S. commercial health plans and the challenges these variations present to patients, clinicians and the health care system as a whole.
- The current state of formulary development practices and priority considerations for stakeholders working to update formulary practices.
Presenters:
- Jennifer Graff, PharmD, Vice President, Comparative Effectiveness Research, NPC
- James Chambers, PhD, MPharm, MSc, Associate Professor of Medicine, The Tufts Medical Center Institute for Clinical Research and Health Policy Studies
- Scott Thompson, Area President, Gallagher Research and Insights