News & Blog

Bloomberg Law: Lost Work, ER Visits Urged in Drug Panel’s Migraine Analysis

Lost work days and time spent in emergency rooms should have weighed more heavily in an analysis of migraine medicines by an influential advisory board, advocates said. The Institute for Clinical and Economic Review, a nonprofit that analyzes whether a drug’s outcome for patients justifies its price tag, can sway insurers’ decisions on drug coverage. It recently determined that Allergan’s Ubrelvy, Eli Lilly’s Reyvow, and rimegepant—a Biohaven drug still being considered for approval by the FDA—aren’t superior to older, cheaper drugs already on the market.

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Inside Health Policy: Advocacy Groups Push ICER To Reevaluate Migraine Drug Analysis

Policy and patient advocacy groups are calling on the Institute for Clinical and Economic Review to rerun its analysis on the cost-effectiveness of three drugs to treat acute migraines, using ICER’s updated framework that considers societal factors. The advocacy groups expect the cost-effectiveness rating of the three drugs would increase further using that framework.

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Politico: ICER Revises Migraine Report, But Advocacy Groups Still Not Satisfied

The Institute for Clinical and Economic Review revised its previous assessment of two new migraine drugs, determining that they meet its long-term cost-effectiveness thresholds — after previously ruling the cost of the medicines was too high. The final evidence report concluded that Allergan’s Ubrelvy, which costs $4,896 a year, and Biohaven’s rimegepant meet the cost-effectiveness threshold.

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We Need to Look Beyond Drugs in Value Assessment

In the United States, we are engaged in the challenging but important conversation about how to assess the value of pharmaceuticals.

While efforts to improve the frameworks for drug value assessment are emerging, we are missing an important opportunity if we continue to focus all value assessment energy on just drugs. To be truly relevant to sustainable value-based health care decision-making, we must advance methods and tools that can effectively support comparative assessment of a broader array of medical interventions.

CLICK HERE to read the full op-ed by Jennifer Bright in Morning Consult.

ICER’s concern for patients: Where’s the beef?

The Institute for Clinical and Economic Review, commonly known as ICER, wants everyone to believe that it cares about patients and that its value assessments of new drugs and treatments are intended to help them.

How do we know that? It’s become the organization’s central talking point as it makes the rounds in advance of finalizing its revised Value Assessment Framework for 2020, which describes the methodology the organization will use in its assessments beginning next year.

We have represented CancerCare, an organization that provides free, professional support services to anyone affected by cancer, in a number of exchanges ICER has had with patient advocacy and support group. We have heard ICER leaders talk about how much they care about patients, how they want to find ways to better capture what value means to patients with a given condition, and how they are trying to make sure that treatments are priced fairly so they can be accessible to those who need them.

Click here to read the full op-ed by Patricia Goldsmith and Carole Florman in STAT News.

Discrimination has no place in American prescription drug coverage

If someone is older, sicker or more disabled, should less value be placed on treating them? Most Americans would be repulsed by the very question. However, one organization is using questionable methodology to determine whether medical treatments are worth it or not for the people most desperately in need.

The Institute for Clinical and Economic Review issues reports about what medications are and are not worthy of being covered by insurance. Unfortunately, ICER relies on arbitrary and unscientific methodology to make its recommendations.

CLICK HERE to read the full op-ed by Sue Peschin in The Tennessean.

ICER Faces New Foe As Patient, Disability Alliance Takes Aims At Reports On Mayzent, Spravato

An article in The Pink Sheet highlighted the Partnership to Improve Patient Care (PIPC)’s involvement with Value Our Health — a new initiative supported by organizations representations patients and people with disabilities. The article highlights Value Our Health’s opposition to the Institute for Clinical and Economic Review’s (ICER) use of the quality-adjusted-life-years (QALY) metric, nothing that the patients groups have long criticized the method as a one-size-fits-all approach to addressing the needs of patients. “It is disappointing that ICER continues to reference the QALY as the ‘gold standard’ despite that it distorts and misrepresents how patients value their own lives, and it can lead to insurers and the government to deny care to people who would benefit from it,” said PIPC executive director Sara van Geertruyden. “There are other ways of conducting value assessment, it’s just they just really don’t have the investment that ICER has.”
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Value Our Health: Stop Discriminatory Value Assessments

Millions of Americans are living with chronic illnesses and disabilities. In generations past, we did not live well or long with these conditions.

Today, scientific advancement has ushered in more innovative therapies and technologies than ever before. Societal evolution has led to policies that have made navigating the world as someone living with one or more of these conditions progressively better.

Cancer patients, for example, are living longer than ever before. They have more options for treatment that can not only extend their survival but can also improve their quality of life.

Through organizations such as the Cancer Support Community, we attend to the social, emotional and logistical burdens many cancer patients and survivors experience. We know that comprehensive, high-quality cancer care must encompass every facet of a patient’s life.

However, this progress comes at a cost. Innovation is expensive, and with high-cost therapies come difficult decisions about scarce health resources.

CLICK HERE to read the full op-ed by Elizabeth Franklin, Cancer Support Community.

Boston drug price watchdog criticized for ‘one-size-fits-all’ approach

A Boston-based watchdog group uses a “one-size-fits-all” approach to determine fair prices for prescription drugs, a mind-set ill-suited for a growing wave of expensive medicines that treat rare diseases, according to a new report by a libertarian-leaning think tank.

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Patient Advocates Say ICER Uses Discriminatory Cost Metrics

A coalition of patient advocates, provider groups and drug makers is criticizing the Institute for Clinical and Economic Review for using a metric they say discriminates against people with disabilities and chronic illness. ICER has responded to the criticism by saying it will include alternative, less controversial metrics in its cost-effectiveness reports. The metric at issue is the Quality-Adjusted Life-Year, which is a commonly used standard internationally to determine the cost-effectiveness of medical treatments, including drugs.

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