Partnering to Support Access and Affordability

Mark Nagy headshot

Today’s guest blog comes from Mark Nagy, Vice President of Global Patient Outcomes and Real World Evidence at Eli Lilly and Company.

In November of 2017, I was elected into a new role as chairman of the National Pharmaceutical Council (NPC) Board of Directors for 2017-2018. Looking back over the past months, one thing is clear: the unpredictable, complex health care system can often fall short of its primary goal, which is to help people live healthier, more active lives.

At NPC, much of our work is focused on the players and factors that shape our system and, subsequently, how to achieve stronger access and affordability for patients. We have been fortunate enough to work with stakeholders from across the health care supply chain on some exciting, forward-thinking initiatives.

A recently published piece in Health Affairs that uncovers the variations in commercial health insurance coverage and reimbursement for innovative, specialty medicines is the most recent example. After analyzing more than three thousand specialty medicines, only one in six drug-indication pairs were covered uniformly across plans, which can create significant uncertainty for patients who switch jobs or coverage plans. The report also found that over one-third of coverage decisions include coverage restrictions or exclusions, which can get in the way of patients accessing the medicines they need.

As the report discusses, improving access and affordability is not easy, but our hope is to partner with other health care players to create solutions. That is why NPC, along with Anthem, is working with the Health Affairs Council on Health Care Spending and Value to help advance a dialogue toward solutions. Over the next three years, we will be issuing a series of collaborative publications and convening thought leaders with the goal of making forward-looking recommendations promoting access and affordability in the health care system. I will share these publications as they are released.

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In addition to our work with Anthem and Health Affairs, we look forward to sharing more on Going Below the Surface, NPC’s initiative examining drivers of health care spending with a solutions-first focus, rather than finger-pointing.

Some of our solutions to improve access and affordability are found in the comments submitted in response to the U.S. Department of Health and Human Services Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs.

As our health care system undergoes quick and unpredictable changes, we must first focus on patients. Through my work with NPC and Lilly, I am fortunate to be able to advance that dialogue to help make life better for people across the country.

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