NCD Pre-Solicitation Notice of Funding Opportunity: State use of QALY-based cost-effectiveness studies for Medicaid prescription drug coverage

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National Council on Disability Pre-Solicitation Notice of Funding Opportunity

State’s use of Quality-Adjusted Life Year (QALY) based Cost-Effectiveness Reports to Inform Medicaid Coverage for Prescription Drugs

The National Council on Disability (NCD) will seek proposals for a report that examines the extent of state’s use of QALY-based cost-effectiveness studies issued by the Institute for Clinical and Economic Review (ICER) or international drug prices set in reliance on QALY based cost-effectiveness research, to inform which prescription drugs and treatments will be covered by their Medicaid programs. The findings in the report serve to assist federal and state policymakers and Congress, with the insight needed to make policy decisions designed to ensure the continued availability of necessary prescription drugs to people with chronic illnesses and disabilities. The report will also provide patient rights organizations, medical associations and educators, and persons with disabilities, with an understanding of health care policies, legislation, and initiatives that impact their lives.

The report will identify the states that are using ICER QALY-based cost studies or  international drug prices to inform Medicaid coverage decisions; will describe how the studies are being used, e.g., as a benchmark or cost-threshold; and will identify if and how reliance on these reports has impacted coverage of drugs and treatments for beneficiaries. It will also describe methodological alternatives to QALYs that consider patient values and preferences. The report will include findings and make recommendations aimed at the U.S. Department of Health and Human Services, state governments, and Congress to address any identified issues and any barriers to accessing prescription drugs caused by reliance on these studies and/or international drug prices.

The estimated contract period is six months. NCD will distribute its Notice of Funding Opportunity on June 15, 2021. NCD expects interested parties to submit their responses by July 20, 2021. Copies of the Notice of Funding Opportunity will be available on grants.gov and ncd.gov. 

This pre-solicitation notice is issued solely for informational and planning purposes only. It does not constitute a Notice of Funding Opportunity. This pre-solicitation notice does not commit the Government to contract for any work or services whatsoever. Further, the National Council on Disability is not at this time seeking proposals and will not accept unsolicited proposals. Respondents are advised that the United States (U.S) Government will not pay for any information or administrative cost incurred in response to this pre-solicitation notice. Responses to this notice are not offers and cannot be accepted by the U.S Government to form a binding contract. It is the responsibility of the interested parties to monitor grants.gov and ncd.gov sites for additional information.

For more information, contact Ana Torres-Davis, atorresdavis@ncd.gov, 1331 F Street, NW, Suite 850, Washington, D.C. 20004, 202-272-2004 or 202-272-2074 TTY.