Value Viewpoint: October 18, 2024

New research published in Medical Decision-Making Policy & Practice explored the direct and indirect costs that Black prostate cancer survivors and their caregivers incurred and how those expenses impacted their lives during and after treatment. The study categorized direct costs as out-of-pocket and insurance-related fees, and indirect costs as unforeseen costs of care, including patient time, caregiver time, lost wages, and transportation:?

Study authors stated:

“We grouped themes into 3 domains and their intersections (i.e., material, behavioral, psychosocial). Participants reported their work and insurance had a significant influence on their finances, treatment costs required rearranging of household budgets, and the weight of indirect costs varied. Ultimately, participants emphasized the significant impact of care costs and the adjustments needed to adapt to them.”

These results point to the need for greater understanding and documentation of cost-sharing information in an effort to support shared decision-making between patients, caregivers, and their healthcare providers.?

On Thursday, the Center for Innovation & Value Research released a new report:? Uncovering the True Cost of Healthcare: Patient Journey Mapping to Inform Economic Impacts. The report is the output of the first of six workshops included in the Patient-Centered Impacts Project and details how patient journey mapping can reveal all the economic challenges that patients and their caregivers face during treatment.

Upcoming webinars of interest:?

IRA Part III: Medicare’s Maximum Fair Prices for the First 10 Negotiated Drugs and Anticipated Cost Savings (Tuesday, October 22, 2024, 10:00 AM EDT). Register here?

• Inmaculada (Inma) Hernandez, PhD,?University of California, San Diego?

• Sean D. Sullivan, PhD,?University of Washington?

• John M. O’Brien, PharmD, MPH,?National Pharmaceutical Council?

• Greg Daniel, PhD, MPH,?Eli Lilly and Company?

Prioritizing Value Assessment for Health Services and Procedures (Thursday, October 31, 2024, 2:00 PM ET). Register here?

• Peter Neumann, ScD,?CEVR?

• M. Christopher Roebuck, PhD, MBA?RxEconomics?

• Paul Fronstin, PhD,?EBRI ?

As a reminder, applications for the PhRMA Foundation’s Value Assessment and Health Outcomes Research Awards are open. The submission deadline is November 15, 2024, with winner notification occurring in March 2025. More information on the application process can be found here.??

If you missed my session at #AMCPNexus on “What You Need to Know About Copay Accumulators, Maximizers, and Alternative Funding Plans,” you can check out a recap and interview:?

• Use of Copay Offset Programs Expected to Rise (Managed Healthcare Executive)?

• Breaking Down Co-Pay Accumulators, Maximizers and the Impact on Patients (AJMC, Part 1)?

??? Eye on ICER?

Calendar with upcoming ICER reports & meetings:?

Reports:?

- 10/21/24: Transthyretin Amyloid Cardiomyopathy — Final Evidence Report?

- 10/31/24: Epstein-Barr Virus Positive Post-Transplant Lymphoproliferative Disease — Revised Evidence Report?

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

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

- 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)?

?