Kimberly Westrich, MA, chief strategy officer of the National Pharmaceutical Council, reflects on the most valuable learnings from the 2024 meeting of ISPOR—The Professional Society for Health Economics and Outcomes Research, including lively discussions of the Inflation Reduction Act and workshops on value assessment.
I connected with colleagues, researchers, students, and health care leaders at the 2024 meeting of ISPOR—The Professional Society for Health Economics and Outcomes Research. The meeting offered a valuable forum for constructive health policy debate, and I’ve distilled several takeaways from the rich conversations and presentations.
1. The Inflation Reduction Act (IRA) remained a hot topic.
Discussion of the IRA took place as uncertainties and potential unintended consequences continue to loom in the wake of CMS’ issuance of draft guidance for the second cycle of Medicare drug price negotiation.
Implementation of the IRA’s drug pricing provisions is underway, yet many unknowns remain about the process and ultimate impact. While some parts of the IRA will help patients—such as caps on out-of-pocket payments and the ability to predictably spread payments over the year—other provisions including changes to Medicare Part D benefit design and the Medicare Drug Price Negotiation Program (DPNP) may result in unintended consequences for biopharmaceutical research and development and patient access to needed medications.
My favorite session on DPNP was the cleverly titled, “Cookbooks vs Blenders: Paradigms for Integrating Factors Relevant to the CMS Drug Price Negotiation Process.” As described by Steve Pearson, MD, MSc, the founder of the Institute for Clinical and Economic Review (ICER), the cookbook approach involves “every factor quantified, or at least explicit weights applied to each factor” and the blender, “every factor qualitative with no categories linked to specific price adjustments.” The best approach may depend on what CMS aims to achieve, which is still unclear. Possible CMS goals identified by Pearson included:
Panelists Kyle Hvidsten, MPH, vice president and head of global health economics and value assessment at Sanofi; Brett McQueen, PhD, assistant professor at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences; and Marina Richardson, PhD, MSc, associate director of HTA methods and health economics at ICER, each recommended some variation of a hybrid approach, with McQueen advocating for the benefits of structured deliberation and Hvidsten highlighting the crucial role of transparency in establishing the credibility of experimental findings. Audience polling on what CMS should/would do showed:
2. Value assessment sessions pushed back on one-size-fits-all methods.
This year’s ISPOR program offered a wide range of panels, breakouts, and research posters on innovative value assessment methods that challenge traditional, one-size-fits-all approaches to assessing the relative value of health care treatments and services. Sessions on distributional cost-effectiveness analysis, multicriteria decision analysis, and generalized risk-adjusted cost-effectiveness identified opportunities for health care decision makers to leverage nontraditional methodologies to inform more holistic value assessments.
3. A welcome focus on employers was evident.
Employers are critical but often overlooked health care stakeholders whose actions have important health care access and affordability implications. I was pleased to see this year’s ISPOR program include dedicated sessions and research posters on crucial topics related to the employer perspective.
An issue panel entitled, “Is the Employer Perspective Sufficiently Reflected in Common Value Frameworks?” highlighted how common value assessment tools such as ICER’s framework and ISPOR’s value flower are primarily focused on the insurer’s perspective and aren’t appropriate for employer decision contexts:
An issue panel moderated by Ulrich Neumann, MBA, MSc, director for market access at Janssen, “Skin in the Game or Financial Overdose? Navigating the Future of Patient Cost-Sharing on Prescription Drugs,” grappled with the realities and unintended consequences of patient cost sharing.
Other employer-focused content included new NPC research highlighting the hidden costs of the 340B program to US employers and employers’ viewpoints on alternative funding programs to pay for patients’ medication costs:
These insights are just a fraction of the breadth and depth of the full conference, so I encourage everyone to take advantage of ISPOR’s Digital Conference Pass Recordings, available from May 22 through June 24. I look forward to hearing others’ key takeaways, and to the digital opportunity to explore some of the many concurrent sessions that I missed!
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