Value frameworks are all the rage of late. But are payers really using them?
According to my colleague Jeremy Schafer, the answer is yes. From an article in Drug Topics:
“Value assessment may become more important as the health-care market shifts to outcomes and value-based reimbursement models,” said Jeremy Schafer, PharmD, MBA, Senior Vice President and Director for Payer Access Solutions at Precision for Value… “Our research has also found that payers currently not using value frameworks either anticipate doing so in the future or are relying on internal cost-effective analyses within their organizations…The most common way payers are using value frameworks is in choosing preferred therapies, comparing products within a class, and policy/pathway development.”
The articles continues to notes a number of limitations of the current value framework, such as their ability to accurately capture a treatment’s effect on patient quality of life as well as the medication’s convenience factor (e.g., injection vs. oral). Schafer even cites the work of the Innovation and Value Initiative, where I serve as the Director of Research.
New initiatives around value, such as one currently under development from the Innovation and Value Initiative, may also help to add transparency by allowing pharmacists and other stakeholders to measure value from a variety of perspectives within a single tool. They may also allow value measurement to be adjusted based on different methodological assumptions.
Do read the whole article.