Value Viewpoint: November 1, 2024

On Tuesday this week, the National Alliance of Healthcare Purchaser Coalitions (the National Alliance) released its annual 2024 Pulse of the Purchaser Survey .

Of interest to those looking through the “value” lens:

• 33% of respondents currently utilize a value-based formulary as opposed to a rebate-driven formulary, with 47% of respondents considering moving to one in the next 1-3 years.?
• Employers that use a value-based formulary versus a rebate-driven one are nearly three times more likely to have lower spending than average.??
• More than half of employers (52%) are considering changing their PBM in the next 1-3 years; the fastest-growing PBM strategies are: confirming transparent revenue disclosure, comprehensive rebate definition, flexibility to customize formulary.?

Speaking of the National Alliance, if you’re attending the upcoming Annual Forum, please join NPC at:

• Monday, November 18: I will be leading the “Engaging Employers to Action: Strategies to Address PBM Misalignment ” workshop and discussion along with panelists Leta Evaskus, Washington State Health Care Authority, Carrie Rust, ELLWOOD Group Inc, Jeffrey Townsend, HealthCareTN, and Renzo Luzzatti, US-Rx Care.
• Tuesday, November 19: John O'Brien will join a panel discussion on "Unlocking Value: Building Trusted Tools to Assess High-Value Care " alongside Sarah Emond, Institute for Clinical and Economic Review, Caroline Pearson, Peterson Center on Healthcare, Shawn Gremminger, National Alliance of Healthcare Purchaser Coalitions, and Nilay Shah, Delta Air Lines.?

On Thursday, ICER posted its revised Evidence Report assessing the comparative clinical effectiveness and value of tabelecleucel for the treatment of Epstein-Barr virus positive post-transplant lymphoproliferative disease (EBV+ PTLD). The report awards a rare grade of substantial net health benefit (“A”) compared with usual care. The report will be reviewed at the virtual public meeting of the New England CEPAC on November 14, 2024.

Also this week, the National Health Council announced the launch of its updated Patient-Centered Value Classroom . The value and health technology assessment field has evolved considerably since the Value Classroom was first launched in 2016 and this update reflects those changes. Updates include:

Patient-Centered Value Assessment Guides:?

• The Patient-Centered Value Assessment Rubric?
• Value Assessment Get-Ready Checklist for Patient Organizations?
• Considerations Guide for Patient Organizations Developing Comments on a Value Assessment??

Recorded Webinars on Alternative Methods to the Quality Adjusted Life Years:?

• Patient Primer: Exploring the Foundations of Patient-Centered Value Assessment?
• Alternatives to the QALY – Generalized Risk-Adjusted QALY (GRA-QALY)?
• Alternatives to the QALY – Health Years in Total (HYT)?
• Alternatives to the QALY – Equal Value Life-Year (evLY)?

Infographics:?

• Pearls of Wisdom from Patient Organizations?
• Pearls of Wisdom from a Health Economist??
• Incorporating the Patient Voice into Value Assessment?
• Value Assessment Terminology?
• Patient-Centered Value Assessment Domains?

Tufts Center for the Evaluation of Value and Risk in Health (CEVR) will host a webinar, “Understanding and implementing selected novel value elements: What you need to know” on November 12, from 1:00 – 2:00 pm ET (register here ).

The Center for Innovation & Value Research is holding the second in its six-part Interactive Workshop Series entitled, “Time is Money: Capturing Time Effects of Economic Impacts ” on November 14, from 1:00 - 3:00 PM ET (register here ). Speakers include:

• Tina Aswani-Omprakash, President at South Asian IBD Alliance,
• Beth Gore, Chief Executive Officer at Oley Foundation
• Casey Quinn, Senior Advisor, Patient-Centered Economic Outcomes at Patient-Centered Outcomes Research Institute.

The workshop will address three questions:

1.????? What economic impacts are most felt as time costs by patients and caregivers?

2.????? What aspects of time are most important to measure?

3.???? How do these time costs differ across various ages, demographics, and socioeconomic backgrounds?

??? Eye on ICER

A calendar of ICER’s upcoming reports & meetings:

Reports:

- 12/9/24: Acute Pain — Draft Evidence Report

- 12/12/24: Unsupported Price Increases Occurring in 2023 — Policy White Paper

- 12/16/24: Epstein-Barr Virus Positive Post-Transplant Lymphoproliferative Disease — Final Evidence Report

- 12/19/24: Fair Access: Coverage Policies in 2024 — Policy White Paper

- 2/5/25: Acute Pain — Revised Evidence Report

- 2/6/25: Retinitis Pigmentosa — Draft Evidence Report

- 3/4/25: Special Assessment to Inform CMS Drug Price Negotiation: Breo Ellipta and Trelegy Ellipta — Final Report

- 3/26/25: Retinitis Pigmentosa — Revised Evidence Report

Meetings:

- 11/14/24: Epstein-Barr Virus Positive Post-Transplant Lymphoproliferative Disease — Public Meeting (New England CEPAC)

- 2/28/25: Acute Pain — Public Meeting (Midwest CEPAC)

- 4/11/25: Retinitis Pigmentosa – Public Meeting (New England CEPAC)

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