Patients, payers, and providers all view value in different ways, and they all need to be taken into account in value frameworks, said Ilene Hollin, PhD, MPH, the National Pharmaceutical Council and University of Southern California Schaeffer Center’s Postdoctoral Health Policy Fellow.
Patients, payers, and providers all view value in different ways, and they all need to be taken into account in value frameworks, said Ilene Hollin, PhD, MPH, the National Pharmaceutical Council and University of Southern California Schaeffer Center’s Postdoctoral Health Policy Fellow.
Transcript (slightly modified)
How do different healthcare stakeholders view value differently?
Different stakeholders view value differently in a few ways. Patients, for instance, when they think about value, they are thinking about “how does this therapy help me achieve my life objectives?” Payers, on the other hand, are think about value and then designing coverage policies accordingly in terms of how to give patients access to the therapies that meet those life objectives, but they also have to balance that with their fiduciary responsibility.
Essentially, this is an issue of balancing patient access and costs. Patients have a bit of a more individual viewpoint when thinking about value, whereas payers have to think on a more population based level.
How can these differing viewpoints be taken into account as new value assessment frameworks are created?
Different viewpoints can be taken into account as more value assessment frameworks are created by tailoring them to the specific end-user. Secondly, by making sure they represent a range of values that account for the spectrum of preferences.
PROs Affirm Zongertinib’s Combination of Strong Response Rates With Low Toxicity
July 1st 2025Joshua K. Sabari, MD, of NYU Langone Health discusses promising results for zongertinib in HER2-mutant NSCLC; the tyrosine kinase inhibitor offers high response rates and improved quality of life with minimal toxicity.
Read More
Blister Packs May Help Solve Medication Adherence Challenges and Lower Health Care Costs
June 10th 2025Julia Lucaci, PharmD, MS, of Becton, Dickinson and Company, discusses the benefits of blister packaging for chronic medications, advocating for payer incentives to boost medication adherence and improve health outcomes.
Listen
Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
Listen
Targeting the Root of gMG With Inebilizumab: A Q&A With Richard Nowak, MD, MS
June 24th 2025In this interview, Richard J. Nowak, MD, MS, principal investigator of the MINT trial of inebilizumab for generalized myasthenia gravis (gMG), discusses the trial’s key findings, including significant improvements in patient- and physician-assessed outcomes, as well as longer-term implications and future areas of investigation.
Read More