Peter J. Neumann, ScD

With a “new normal” level of care going forward post coronavirus disease 2019 (COVID-19), the key will be to invest in high-value services while deterring a resurgence of low-value care.

This review presents a set of evidence-based outcome measures for oncology alternative payment models, drawing on evidence from existing and proposed quality measures.

Health plans restrict orphan drug coverage less often than nonorphan drug coverage. However, the frequency of restrictions varies considerably across plans.

New value frameworks should incorporate real-world evidence that reflects patient treatment behavior, adherence to medication, and equity concerns arising from disparities in care.

The authors examine the largest 20 US commercial payers’ coverage policies and identify variation in how interventions are covered and the evidence reviewed in them.

The authors review empirical evaluations of drug exclusion policies to examine their impact on patients and on healthcare costs.

Assessment of current trends, success factors, and challenges in the use of risk-sharing agreements in the US private sector.

This study's findings showed that diabetes care remained suboptimal among many patients with multiple chronic conditions and that patient outcomes varied by multimorbidity profile.

This study examines whether patients treated with specialty pharmaceuticals have improved outcomes compared with patients treated with conventional therapies, and evaluates costs associated with these treatments.

Building negative incentives into value-based insurance design programs to discourage use of low-value care will involve a number of challenges.

A systematic literature review from 1998 to 2003 showed that few cost-effectiveness analyses of self-administered medications model suboptimal medication adherence.

A panel composed of medical and pharmacy directors expressed strong support for a greater role for cost-effectiveness analysis in US health policy decisions.