Blue Cross Blue Shield Association Announces New Specialty Pharmacy Drug Effectiveness Measures

Chicago – The Blue Cross Blue Shield Association (BCBSA) National Council of Physician and Pharmacist Executives (NCPE) adopted a set of clinical effectiveness measures to assist in evaluating which specialty drug therapies are most beneficial for members. By establishing more consistent measures of relative effectiveness, medical professionals and their patients will benefit from such information when making treatment choices.  In addition, the measures will increase the efficiency of evaluating specialty drugs to better assist members in getting access to the most effective medications.

The measurements were unanimously supported by the NCPE, a committee that includes pharmacy experts from Blue Cross and Blue Shield (BCBS) companies around the nation. The measures selected were:

  • Number Needed to Treat and Number Needed to Harm: Measures the benefits and harms of a medication.
  • Persistence: Measures how long patients take a drug and whether the drug is consistently taken by patients.

By using these two measures as part of the evaluation process, BCBS companies will gain greater insight and access to real-time information about how members are adapting to the medications they’re using and will further understand which drugs are most beneficial.

“By adopting this consistent set of measures, BCBS companies are providing leadership and clarity in a much needed area of health care,” said Dr. Trent Haywood, senior vice president and chief medical officer for BCSBA. “With this approach, we look forward to continuing to make health care work better and more efficiently for everyone.”

The NCPE worked with Prime Therapeutics to identify the best measurements for a system-wide adoption.

"This is an important move to improve quality for BCBS members and a key step toward helping to ensure the value of specialty pharmacy drugs," added Dr. Jonathan Gavras, chief medical officer, Prime Therapeutics.

About Blue Cross Blue Shield Association

The Blue Cross and Blue Shield Association is a national federation of 36 independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide health care coverage for one in three Americans. BCBSA provides health care insights through The Health of America Report series and the national BCBS Health Indexsm. For more information on BCBSA and its member companies, please visit We also encourage you to connect with us on Facebook, check out our videos on YouTube and follow us on Twitter.

The Blue Cross Blue Shield Association is an association of 36 independent, locally operated Blue Cross and/or Blue Shield companies.