Today I participated in a fantastic panel presentation at the 2018 Academy of Managed Care & Specialty Pharmacy Conference in Boston. Moderated by Jonathan Collar of Cigna-Health Spring, the session discussed “New Tools for Measuring Treatment Value in Rheumatoid Arthritis“. My co-presenters were Jeroen Jansen from the Innovation and Value Initiative and Dr. Jeff Curtis, a rheumatologist for the University of Alabama Birmingham. Dr. Jansen spoke about value frameworks in RA including IVI’s Open-Source Value Project (OSVP); Dr. Curtis discussed novel data sources for measuring value in RA; and I presented some approaches for adapting the data and value measurements produced into pricing and formulary management decisions. The session overview is below.
Summary
Managed care pharmacists face considerable challenges in managing formulary decisions for patients with rheumatoid arthritis (RA). Not only are there numerous RA treatments, but many of these treatments are high-priced. The increasing complexity of managed care pharmacy decisions for rheumatoid arthritis has prompted a rising need to better understand how to measure the value of rheumatoid arthritis treatments and understand the evidence upon which assessments are based.
In this session, we discuss tools available to managed care pharmacists to measure the value of RA treatments as well as how to use those tools to inform cost and utilization management strategies. In addition, we will discuss how information on patient clinical markers may help inform targeted utilization management programs.
Learning Objectives:
At the completion of this activity, participants should be able to:
- Describe the landscape of value assessment approaches and frameworks as they apply to rheumatoid arthritis (RA).
- Discuss academic, payer, and pharmaceutical perspectives on value-based pricing within RA management.
- Explain innovative contracting and pricing approaches for RA treatment management.
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