1. PIPC Webinar: Value Assessments and Their Impact on Patients, click here to register.
2. Op-ed: The U.S. Shouldn't Use the 'QALY' in Drug Cost-Effectiveness Reviews, click here to read the op-ed.
3. Alliance for Aging Research: Governors Should Reject Unscientific and Discriminatory Approaches to Drug Pricing, click here to read the op-ed.
4. PIPC Submits Comment Letter to ICER on International Collaborative to Develop New Methods to Guide Value-Based Pricing of Potential Cures, click here to read the letter.
5. Upcoming IVI Webinars, see details below.
6. Review and Comment! IVI Releases New Value Assessment Platform for Non-Small Cell Lung Cancer Therapy Sequences, see details below.
7. PCORI Advisory Panel Openings, see details below.
8. PIPC Submits Comments to DoD on Proposed TRICARE Pharmacy Benefit Reforms, click here to read the letter.
9. Submit 2019 Fly-ins, Advocacy Days, and Conferences to Democratic Caucus, click here to submit your events.
10. International News: What Happens in Countries Using QALYs and Cost-Based Thresholds to Determine Coverage? Click here to view.
11. ICER Studies: SMA, Depression, MS, Duchenne Muscular Dystrophy, Peanut Allergy click here to provide patient input
12. Upcoming Events and Webinars, see details below.
13. Medical Journal Articles, see details below.
14. AHRQ Effective Program Updates, see details below.
The Partnership to Improve Patient Care (PIPC) invites advocates representing people with disabilities, patients, seniors, individuals experiencing disparities in care, providers and others to join our webinar to learn about value assessments, their potential for discrimination, and related public policy threats to beware of at both the federal and state level. Metrics for measuring the “cost effectiveness” or value of treatments often relies on the quality-adjusted-life-year (QALY), which inherently discriminate against people with disabilities and serious chronic conditions. This webinar will arm advocates with the information they need to oppose discriminatory value assessments from being incorporated into public programs such as Medicare and Medicaid that ultimately are used to deny coverage and access to patients. The webinar will be held on Feb. 26 from 1:30-2:30 PM. Click here to register. Click here to view an accessible PDF. CART captioning for the webinar can be accessed here.
2. Op-ed: The U.S. Shouldn't Use the 'QALY' in Drug Cost-Effectiveness Reviews
In an op-ed for STAT News, Dr. William Smith argues against the use of the QALY metric in drug cost-effectiveness -- citing PIPC Chairman Tony Coelho's response to a recent blog post entitled “Will ICER’s Response to Attacks on the QALY Quiet the Critics?” "There are other reasons for people to worry about the use of quality-adjusted life years. A cancer drug that provides “only” eight additional months of life won’t achieve a maximum QALY score. Yet to someone with a cancer treated by that drug who may be facing certain death, a drug that delivers an extra eight months of life should get the highest possible rating. The use of QALYs in the United Kingdom’s National Health Service so limited Britons’ access to new cancer therapies that Parliament ignored the QALY methodology entirely and created a 'Cancer Drugs Fund' that would pay for new cancer drugs regardless of their QALY ratings." Click here to read the op-ed.
3. Peschin: Governors Should Reject Unscientific and Discriminatory Approaches to Drug Pricing
In an op-ed for The Hill, PIPC Steering member, the Alliance for Aging Research CEO Susan Peschin, writes about the discriminatory effects of ICER's QALY metric. "ICER relies on 'black box' models and its budget targets vary with the count of FDA approvals. Unfortunately, there is little transparency into exactly what goes into ICER’s formulations or how they arrive at their conclusions. This means other researchers and even payers are unable to analyze and replicate ICER’s results. Research has also found that the QALY approach produces arbitrary results, so it does not have a sound scientific foundation despite the complex calculations." Click here to read the op-ed.
4. PIPC Submits Comment Letter to ICER on International Collaborative to Develop New Methods to Guide Value-Based Pricing of Potential Cures
In a letter to the Institute for Clinical and Economic Review (ICER), the Partnership to Improve Patient Care (PIPC) offered suggestions to ICER on the development of new methods to guide value-based pricing of potential cures. The letter encourages ICER to acknowledge the long-term health benefits and cost savings resulting from curative therapies, and work with foreign collaborators to develop more patient-centered methods for value assessment that do not impede access. "While there is no single alternative method that succeeds on all domains at present, we are encouraged that several other organizations and approaches are underway in developing value assessment models that better reflect principles of patient-centeredness," wrote PIPC Chairman Tony Coelho. "We applaud ICER for recognizing the need to improve affordability for patients, and hope you take this opportunity to learn from the ongoing efforts of others to develop patient-centered methods for value assessment that incorporate a range of evidence to determine coverage and care decisions, and reject a single, one-size-fits-all measure of value." Click here to read the letter.
5. Upcoming IVI Webinars
The Innovation and Value Initiative (IVI) is hosting two webinars this week, providing a general overview of the new Open-Source Model for Non-Small Lung Cancer, as well as an in-depth discussion of technical and methodological aspects of the IVI-NSCLC model.
Advancing the Science of Value Assessment: New Open-Source Model for Non-Small Cell Lung Cancer
Date: Today at 3 PM EST/12 noon PST
Content: General overview for all audiences
The OSVP is designed to improve how we measure value through an iterative and transparent process driven by input from all health care stakeholders. Join us for a webinar to better understand how the OSVP process works, learn about our recently released model in non-small cell lung cancer, and find out how to get involved. Click here to register and reserve your spot.
Modernizing Models for Value Assessment: A Detailed Discussion of the Open-Source IVI-NSCLC Model
Date: February 27, 2019 at 2:30 PM EST/11:30 AM PST
Content: In-depth discussion of technical and methodological aspects of the IVI-NSCLC model
OSVP models are built to be entirely open-source, allowing anyone to customize the tool depending on their own assumptions and understanding of value. Join us for a webinar to learn more about how the IVI model generates customized information on non-small cell lung cancer treatments and how to apply the information in assessing value in health care. Click here to register and reserve your spot.
6. Review and Comment! IVI Releases New Value Assessment Platform for Non-Small Cell Lung Cancer Therapy Sequences
IVI recently released the initial version of its new Open-Source Value Platform (OSVP) model for non-small cell lung cancer. Specifically, the platform will be assessing the relative value of sequential treatments for epidermal growth factor receptor positive (EGFR+), non-squamous non-small cell lung cancer (NSCLC).
IVI, a nonprofit organization dedicated to advancing the science and improving the practice of value assessment in healthcare, has now developed two open-source platforms from which healthcare value assessment tools can be built and utilized. The entirety of IVI’s modeling package, including a dynamic and engaging user interface, can be found IVI’s website.
The public comment period will remain open until April 1, 2019 and IVI encourages stakeholder comment on their model. The feedback received during this public comment period will provide the basis for improving the model. IVI has engaged an external technical expert panel to synthesize comments and recommend prioritized modifications for inclusion in the second release of the IVI-NSCLC platform.
For more information contact IVI’s executive director, Jennifer Bright at [email protected].
7. PCORI Advisory Panel Openings
PCORI is now accepting nominations and applications for new members of four of its advisory panels: Health Delivery and Disparities Research, Patient Engagement, Clinical Trials, and Rare Disease. PCORI’s advisory panels provide important guidance on everything from refining and prioritizing research questions for potential funding, to offering feedback on the design of research studies, to engaging patients as partners throughout the research process. If you are interested in serving on a panel or would like to nominate a candidate, the deadline to submit applications and nominations is Friday, March 29. You can find details about each panel and the application process here: http://bit.ly/advisorypanels
8. PIPC Submits Comments to DoD on Proposed TRICARE Pharmacy Benefit Reforms
In a comment letter to the Department of Defense (DoD), Partnership to Improve Patient Care (PIPC) offered feedback on the interim final rule concerning the TRICARE Pharmacy Benefit Programs. The letter encourages DoD to avoid adopting "one-size-fits-all" value metrics, and promote a TRICARE program that mitigates discrimination against people with disabilities and serious chronic conditions.“…We recommend the creation of an infrastructure for patient and beneficiary engagement in uniform formulary development under Tricare, to give members of the military and their families a voice in the determination of the value of treatments under the program, and throughout Tricare,” wrote PIPC Chairman Tony Coelho.
“We also recommend the incorporation of incentives for health care providers to use shared decision-making tools and decision aids that will enhance the ability for patients and their physicians to assess the highest value treatment for that individual patient. In this way, Tricare can deliver on the intent of this program to deliver high value care by arming beneficiaries with information to improve health decisions instead of putting hurdles in front of the care they need.” Click here to read the letter.
9. Submit 2019 Fly-ins, Advocacy Days, and Conferences to Democratic Caucus
In the interest of amplified patient and stakeholder engagement, your organization may be interested that the House Majority Leader’s office is compiling a list of fly-ins, advocacy days, and conferences that will be taking place throughout the year. This information will be shared with all House Democratic offices and used for a variety of purposes including scheduling and messaging. Feel free to share any events you have planned. If we hear of similar efforts by the Minority Leader, we hope to share that as well. Please submit your events, here.
10. International News: What Happens in Countries Using QALYs and Cost-Based Thresholds to Determine Coverage?
Other countries are often referenced as examples of how the use of QALYs or similar cost-based thresholds impact access to care.
- New Zealand: Breast cancer patients are not receiving access to to life-saving medications. As a result of widespread criticism, PHARMAC is set to review its practices of breast cancer drug funding. Click here to read more. Patients in New Zealand also face barriers to access for treatment of spinal muscular atrophy. Click here to read more.
- Canada: Discriminatory cost effectiveness measures are blocking access to care for patients with spinal muscular atrophy patients. Click here and here to read more. Click here to view the story of a child with thyroid cancer forced to come to the U.S. for care, and here for an article about high costs of Parkinson's and MS treatments.
- Netherlands: Cost effectiveness measures are blocking access to cystic fibrosis treatments for children. It also remains unavailable for adults because the government has failed to reach an agreement. Click here to read more.
- United Kingdom: Activists are fighting for access to treatments for cystic fibrosis and cancer. Click here, here, and here for articles related to cystic fibrosis. Click here and here to read about the fight for access to cancer drugs in Scotland. Click here for an article related to MS. Click here for more information on the NHS drug approval process.
11. ICER Studies: SMA, Depression, MS, Duchenne Muscular Dystrophy, Peanut Allergy
The Institute for Clinical Economic Review (ICER) conducts cost effectiveness studies for insurers using the cost-per-QALY methodology. ICER provides guidance on its website for patients and patient advocates to provide direct input related to their experiences with the disease. Click here to provide patient input. Click here to view the topics and deadlines. Please note the following upcoming formal ICER deadlines per their website:
- Spinal Muscular Atrophy: 3/7/2019 Meeting: New England CEPAC to deliberate and vote on ICER's report on treatments for SMA. Evidence Report now available.
- Depression: Model Advancement Plan: 2/4/2019. Meeting 5/23/2019: Midwest CEPAC to review evidence on esketamine as a therapy for treatment-resistant depression.
- Multiple Sclerosis: Revised scoping document available on treatment for secondary progressive multiple sclerosis. Research Protocol: 1/14/2019 . Model Advancement plan: 1/29/2019. Meeting 5/23/2019: Midwest CEPAC to review ICER's assessment of siponimod (Novartis) for secondary progressive multiple sclerosis.
- Peanut Allergy: Stakeholder list available. Revised Scoping Document: 12/20/2018. Draft Evidence Report: 4/9/2019. Meeting 6/11/2019: CTAF to review ICER's assessment of treatments for peanut allergy.
- Duchenne Muscular Dystrophy: Draft scoping document available. Meeting 7/25/2019: New England CEPAC to deliberate and vote on evidence presented in ICER's report on treatments for Duchenne muscular dystrophy.
- Unsupported Price Increase Assessment: Draft protocol available.
12. Upcoming Events and Webinars
Advancing the Science of Value Assessment: New Open-Source Model for Non-Small Cell Lung Cancer
February 25, 2019
Click here for details.
PCORI Board of Governors Meeting
February 26, 2019
Click here for details.
Modernizing Models for Value Assessment: A Detailed Discussion of the Open-Source IVI-NSCLC Model
February 27, 2019
Click here for details.
Webinar: Amplifying the Patient Voice: Policy Solutions for Improving Patient-Reported Measures in Oncology Value-Based Payment Programs
February 28, 2019
Click here for details.
Health Affairs Briefing: Patients As Consumers
March 5, 2019
Click here for details.
PCORI Board of Governors Meeting
March 19, 2019
Click here for details.
NPC @ National Quality Forum Annual Conference
March 24-26, 2019
Click here for details.
NPC @ Health Datapalooza 2019
March 27-28, 2019
Click here for details.
Advisory Panel on Clinical Trials Spring 2019 Meeting
May 15, 2019
Click here for details.
Advisory Panel on Healthcare Delivery and Disparities Research Spring 2019 Meeting
May 16, 2019
Click here for details.
2019 NEC Symposium
June 2 - 5, 2019,
Click here for details.
A New Path Forward for Using Real World Evidence in Randomized Clinical Trials
June 23, 2019,
Click here for details.
13. Medical Journal Articles
How Patient's Access to Evidence-Based Medicine Provides Them with a New Hope "The 45 Min—An Insightful Round," click here to view.
Improving Patient-Reported Measures in Oncology, click here to view.
Moving Forward from Drug-Centred to Patient-Centred Research, click here to view.
Eliciting Patient-Important Outcomes Through Group Brainstorming: When Is Saturation Reached? Click here to view.
Patient-Community Perspectives on Real-World Evidence: Enhancing Engagement, Understanding, and Trust, click here to view.
A Narrative Review of Data Collection and Analysis Guidelines for Comparative Effectiveness Research in Chronic Pain Using Patient-Reported Outcomes and Electronic Health Records, click here to view.
A Patient-Centered Approach to Comparative Effectiveness Research Focused on Older Adults: Lessons From the Patient-Centered Outcomes Research Institute, click here to view.
Editorial: Evaluating Patient and Public Involvement in Research, click here to view.
Developing a Patient-Centered Outcome for Targeting Early Childhood Obesity Across Multiple Stakeholders, click here to view.
Cancer Patient Perspectives on the Use of Clinical Pathways and Shared Decision-Making in Cancer Care, click here to view.
14. AHRQ Effective Program Updates
Treatment of Acute Pain: An Evidence Map, click here to view.
Development of Harmonized Outcome Measures for Use in Patient Registries and Clinical Practice: Methods and Lessons Learned, click here to view.
Standardized Library of Depression Outcome Measures, click here to view.
Patient Navigation Models for Lung Cancer, click here to view.
Stroke Prevention in Patients With Atrial Fibrillation: A Systematic Review Update, click here to view.
Long-term Drug Therapy and Drug Holidays for Osteoporosis Fracture Prevention: A Systematic Review, click here to view.
Addressing Social Isolation to Improve the Health of Older Adults: A Rapid Review, click here to view.
Labor Dystocia, click here to view.
Nonsurgical Treatments for Urinary Incontinence in Women: A Systematic Review Update, click here to view.