Value Viewpoint: August 15, 2025

Kimberly Westrich

NPC Chief Strategy Officer | Kimpossibility Coaching, Retreats, & Yoga | Biopharmaceutical & Health Policy Researcher | Public Speaker

Published Aug 15, 2025

Last week, a new article in Health Affairs proposed a framework for incorporating health technology assessment (HTA) methods into the Medicare Drug Price Negotiation Program (DPNP). The framework consists of four components:

Selecting therapeutic alternatives, including the public identification of possible alternatives and soliciting evidence on each;
Assessing the value of the drugs selected for negotiation by considering health outcomes, economic impacts, and ethical and contextual factors;
Using a decision matrix for weighting the multiple negotiation factors; and
Including an independent advisory committee to deliberate on the accumulated clinical and economic evidence.

About their framework, the authors say:

“…our proposal contains specific approaches for expanding patient and public engagement across multiple steps in the negotiation process. Moreover, it combines clinical, economic, and other information to inform a Maximum Fair Price offer based on weightings for a decision-making process that is transparent and replicable.”

The August 2025 issue of Value in Health was published recently and has a number of interesting articles:

Implementing the Generalized Risk-Adjusted Cost-Effectiveness Model for Sickle Cell Disease: A Case Study (see the June 6 Value Viewpoint for my previous write-up)
Synergizing Needs Assessments and Patient Preference Studies for Enhanced Patient-Centered Decision Making in Healthcare (see the May 23 Value Viewpoint for my previous write-up)
A Comprehensive View of the Methods Used to Measure the Societal Impact of Healthcare Interventions: A Systematic Review (see the Mar 9 Value Viewpoint for my previous write-up)
Addressing Subgroup-Specific Treatment Effects to Avoid Inefficient Care: The Conflict Between Statistical and Health Economic Analyses explores patient sub-group heterogeneity including whether it is reflected in cost-effectiveness analysis and how it may influence reimbursement decisions.
The Increasing Use of Clinical Outcome Assessments in US Food and Drug Administration Labels and the German Gemeinsamer Bundesausschuss, National Institute for Health and Care Excellence, and the French Haute Autorité de Santé Assessments From 2012 to 2022 examines trends in the inclusion of clinical outcome assessments (COAs) in FDA labels and European HTAs.
The Value of Hope in Cancer Care: Risk Preference and Heterogeneity in Cancer Patients and the General Public (paywalled) seeks to quantify the value of hope in cancer care from both patient and general public perspectives.

A new article (paywalled) published in Value in Health estimates the incorporation of informal caregiving time for older adults (50+). Highlights identified by the authors include:

“This study introduces models using U.S. nationally representative data to estimate informal caregiving time based on patients' health-related quality of life and functional limitations.”

“The models demonstrate strong predictive accuracy and highlight that caregiving time increases as patients' health declines.”

“These models provide researchers with practical tools to estimate caregiving time when direct data are lacking, supporting more comprehensive economic evaluations from a societal perspective.”

The PhRMA Foundation is now accepting applications for its Value Assessment & Outcomes Research 2026 Fellowships and Grants. Funding levels include predoctoral fellowships ($30,000 a year for up to two years), postdoctoral fellowships ($60,000 a year for up to two years), and faculty starter grants ($100,000 for one year). A webinar about the application process will be held on September 3, 2025, and applications are due by October 30, 2025.

There are two recent publications from NPC I’m eager to share:

Prescription Drug Utilization and Spending by Race, Ethnicity, Payer, Health Condition, and US State provides an in-depth analysis of the variation in prescription drug utilization, spending per capita, and spending per prevalent case by race, ethnicity, health condition, payer, and U.S. state. The study finds that significant racial and ethnic disparities exist in prescription drug utilization and spending in the U.S., with Black populations experiencing underutilization of medications after adjusting for age and disease prevalence.
Access to Fair Prescription Plans Can Make Employees Healthier explores how employers are uniquely positioned to address pharmacoequity considerations, such as employee medication affordability and access barriers within their benefit design. By examining pharmacy benefits claims data, learning from employees, and implementing interventions such as value-based insurance design and wage-based benefits subsidies, employers can enhance both employee health and business outcomes.

👁️ Eye on ICER

A calendar of ICER’s upcoming reports & meetings:

Policy White Papers/Special Assessments:

- 10/23/25: Launch Price and Access Report: Drug Approvals from 2023-2024 — Final Report

- 1/22/26: HEMA Final Report — Defining Appropriate Benefits for Economic Evaluation of Health Care Technologies

Value Assessment Reports:

- 9/2/25: Spinal Muscular Atrophy — Final Evidence Report

- 9/8/25: Non-Cystic Fibrosis Bronchiectasis — Revised Evidence Report

- 9/9/25: Obesity Management — Draft Evidence Report

- 10/20/25: Smoking Cessation — Draft Evidence Report

- 10/27/25: Non-Cystic Fibrosis Bronchiectasis — Final Evidence Report

- 10/29/25: Obesity Management — Revised Evidence Report