NCPDP PTI Roundtable for VBA

On 8/30/21, I had the honor of co-chairing the first roundtable from NCPDP's (National Council for Prescription Drug Programs) PharmTechnology Innovation (PTI) Accelerator.  Our presenters discussed the different elements related to value-based agreements (VBA). Our incredible speakers included:

• John W. Hill, MBAHCM, CNED, Executive Vice President & GM with the National Council for Prescription Drug Programs (NCPDP)
• Laura Topor, Cognizant Consulting, and co-chair of NCPDP's Specialty Pharmacy Work Group
• Ben Shirley, Director of Performance Measurement at the Pharmacy Quality Alliance (PQA)
• Paul Howard, Ph.D., Director of Public Policy at Amicus Therapeutics

The PTI Roundtables created an open dialogue environment. Rather than focus on presentations, we encouraged all to share their thoughts and comments. Each guest was welcome to share as they felt comfortable.Throughout the discussion, we highlighted the progress and challenges under the VBA umbrella:

• Laura provided context on the NCPDP standards and transactions, including REMS and the HL7 Specialty Medication Enrollment Guide efforts led by Work Group 18. They are looking forward to piloting in order to gain traction.
• Ben described PQA's process to establish standards, framing the near, mid, and long-term goals. He emphasized the importance of bringing everyone together, provider, payor, and pharmacist, to drive change in favor of patients.
• Paul pointed out that over 500 gene programs are under development in the US, most with curative intent. He also discussed the challenge of balancing the portability of longitudinal measurement requirements across payers with the uncertainty of risk and safety at launch.

In addition, guests on the call highlighted:

• CMMI exploration in VBA with CPESN and MTM programs
• HL7's Gravity Project
• The opportunity for patient-facing apps to mobilize patient-reported data. On this, an opinion paper published in HealthCare: The Journal of Delivery Science and Innovation
• The impact of having a diagnosis on scripts.  On this a couple perspectives on StatNews and JMCP.

The infographic link below summarizes the Value-Based Arrangements (VBA) Framework that NCPDP is considering based on NCPDP membership guidance.  It will help to identify current and potential new standards that enhance workflow and real-time, structured data to drive value-based care. At this time, NCPDP has identified two paths to support this overall initiative: (1) Data/Reporting and (2) Clinical. See infographic here.