The Five Rights Framework
To drive collaboration to control cost, reduce waste and maximize effectiveness of specialty drugs, the National Alliance has developed stakeholder guidelines and an engagement framework targeting critical issues and opportunities for specialty stakeholders including manufacturers, providers, health plans, and pharmacy benefit managers.
- Developed to raise purchaser expectations for what to expect out in the marketplace
- Helps industry stakeholders better understand, evaluate and improve the specialty drug marketplace.
- Base practices and decisions on clinical efficacy and safety independent of conflicted interests/PBMs accept ERISA fiduciary status
- Cover testing that supports improved assessment of correct drug, doses and duration of treatment for specific patient
- Require purchaser transparency and engagement on key issues and National Drug Codes used by all providers, in all settings related to: prior authorization, utilization management, payment & rebates, claim level reporting, data analysis, provider contracts, patient outcomes, and quality improvement
- Align value based contracting with performance and adherence to high value drugs with correct doses and duration consistent with guidelines
- Require cost parity or benefit differentials across sites of care for same drugs and services
- Support patients on drug administration and needed emotional/social support to increase adherence and improve outcomes
- Discontinue conflicting practices such as low value coupon programs, drug price increases more than Consumer Price Index, and exclusion of high value delivery options.
Looking for more information?
View 2017 Press Release
Download the infographic here!