CER Comparative Effectiveness Current Events

Nothing NICE about ICER?

On it’s website, the Instititute for Clinical and Economic Review (ICER) claims that it is “…a trusted non-profit organization that evaluates evidence on the value of medical tests, treatments and delivery system innovations and moves that evidence into action to improve the health care system. ”

A recent article in Huffington Post however, disagrees.  They make two key points.

First, although ICER claims to be independent, the ICER framework is clearly implemented from a payer (i.e., health insurer) point of view.  ICER’s own website says:

ICER led an initiative to develop a conceptual framework which insurers can apply to guide their assessment of the value of medical services, including drugs, medical devices, and procedures.

HuffPo also notes that the majority of the board of directors are from insurance companies.

Second, because ICER takes a payer perspective, it does not take into account all the factors that patients value.  For instance:

And “benefits” to a patient may include non-economic items such as living long enough to see lifecycle events — marriages, births, graduations and weddings, those moments that make life worth living in the first place. sadly, these unquantifiable experiences have no place in the value calculations done by those that rely on spreadsheets, apps or an abacus to apportion care.

To address this shortcoming, ICER did add two patient advocacy experts to their Governance Board. It remains to be seen, however, how their perspectives will be incorporated into ICER’s modeling decisions.

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