When defining value, the Alliance for Patient Access emphasizes a patient-centered approach. Value to a patient might mean something different than value means to an insurer, state review board or health technology assessor. AfPA seeks to ensure patient and clinician voices are informing conversations around value and reinforce appropriate access to care.
Prescription drug affordability boards, or PDABs, are state-level boards that aim to lower medication spending for the state. But they can cause problems for patients. PDABs limit the state’s payment for certain medications, unintentionally reducing treatment options for clinicians and patients.
Health technology assessments and the organizations that conduct them often play an outsized role in determining access to new therapies. When determining value, it is critical to ensure that the patient and clinician perspective is not just acknowledged but incorporated as a major component of these reviews. In addition, ensuring a comprehensive approach and minimizing discriminatory metrics like the QALY, will prioritize individual differences between patients.
The Institute for Clinical and Economic Review, or ICER, is a private, Boston-based health economics organization that analyzes clinical trial data in an attempt to gauge medications’ cost-effectiveness. ICER’s reports often influence health plans’ decisions about how, or whether, to cover new drugs.
The Alliance for Patient Access works to educate, train and mobilize the advocacy and clinician community to engage throughout the process and make sure the patient experience is shared and prioritized as ICER completes these reviews.
