The National Health Council (NHC) appreciates the opportunity to submit comments in response to the request for information (RFI) from the Committee on Health, Education, Labor, and Pensions (HELP) on recommendations to lower health care costs.
Founded in 1920, the NHC is the only organization that brings together all segments of the health community to provide a united voice for the more than 160 million people with chronic diseases and disabilities and their family caregivers. Made up of more than 125 diverse national health-related organizations and businesses, the NHC's core membership includes the nation’s leading patient advocacy organizations, which control its governance and policy-making process. Other members include professional and membership associations; nonprofit organizations with an interest in health; and representatives from the pharmaceutical, generic drug, health insurance, device, and biotechnology industries.
Over the last few years, the NHC has conducted numerous listening sessions with CEOs of patient organizations, asking them to describe the most significant challenges their constituents currently face. While patient organizations care deeply about driving innovation to help their constituents improve how they feel, function, and survive, they are equally or more concerned about affordable access to high-value care. People with life threatening conditions without effective treatments such as certain types of cancer, neurological, and rare diseases are finding significant access barriers to routine care, and those with historically inexpensive, yet effective, treatments like heart disease have found their costs rising dramatically.
That is why in the fall of 2016, the NHC’s Board of Directors began to analyze current policies and proposals designed to curb health care costs. The NHC evaluated nearly 200 proposals intended to address health care costs broadly, including drug prices. The NHC is committed to increasing access to sustainable, affordable, high-value care through personalized caremanagement.1 We do not support policies that achieve savings if they negatively impact patient safety, quality, or access to care. The NHC updated these policies in March 2019 to reflect changes in the policy landscape since the original analysis and document were published.
First and foremost, any effort designed to reduce health care costs must be predicated on value. Over the course of the last several years, we have seen a growing interest in and debate around defining value. However, many of those discussions have not adequately included patients, and value must be defined from the patient perspective. As multi-stakeholder consensus on measuring and assessing value is achieved, we will be able to better assess cost savings and the impact of health care.
Keeping this in mind and based on the evaluation of existing policy proposals, the NHC developed a patient-centered framework with three driving principles, listed below, and 18 specific patient-centered values to guide our recommendations:
- Promote high-value care;
- Stimulate research and competition; and
- Curb costs responsibly.
The NHC and its Board, with input from its members, identified four main policy priority areas that have the potential to reduce costs for patients and the health care system:
- Reduce barriers for development of generic and biosimilar products, and expedite approval of certain generic applications;
- Promote meaningful transparency on price and cost sharing;
- Encourage outcomes-based contracting; and
- Facilitate the implementation of value-based insurance design.
Attached to this letter are our specific policy recommendations to help achieve these goals to promote lower health care costs and improved patient outcomes.