ICER’s updated process for determining unsupported price increases (UPI)

Last month, ICER updated their protocol for identifying drugs that have unsupported price increases (UPI). Not only is ICER examining rising drug prices, but California and Vermont now have laws tracking substantial drug price increases, requiring drug manufacturers to submit information that might justify increases above a certain threshold. ICER says that the UPI reports…

How ICER will conduct it’s “Barriers to Fair Access” Assessment

Last fall, ICER published a white paper titled “Cornerstones of ‘Fair’ Drug Coverage: Appropriate Cost-Sharing and Utilization Management Policies for Pharmaceuticals.” To paraphrase, ICER’s goal is to limit access restrictions (e.g., cost sharing, coverage limitations, prescriber restrictions, step therapy) when a drug is deemed to be cost effective. How will they do this? Their Barriers…

Payer use of ICER reports

The Academy of Managed Care Pharmacy (AMCP) held an interesting webinar titled “5 Years of ICER – Insights and Impact on Payers“. Some highlights form the presentation. Most relevant information Jeremy Lee from MedImpact–a pharmacy benefits manager (PBM)–noted that their Pharmacy and Therapeutics (P&T) committee used four key pieces of evidence when making coverage and…

Healthcare Economist in the Wall Street Journal

How do you measure the value of new drugs? An organization known as the Institute for Clinical and Economic Review relies almost exclusively on Quality-Adjusted Life Years (QALY)-based framework. While that is a good start, many new treatments may have impacts beyond directly on health including on educational outcomes, productivity, caregiver burden. Further, society is…

Measuring the value of pharmaceuticals over time

Measuring treatment value is difficult. Costs are relatively easier to measure but benefits are often more difficult, particularly impact on caregiver burden, productivity, quality of life and other factors. Not only that, but the “benefits” that accrue to a person may vary by individual. Some individuals may prefer treatments that are more effective, but with…

ICER and Unsupported Price Increases

The Institute for Clinical and Economic Review (ICER) recently announced that it would annually review treatments with significant price increases to determine if these changes are unsupported by evidence on value. I was recently interviewed by Radar on Specialty Pharmacy to discuss the topic. Jason Shafrin, Ph.D., a senior director of policy and economics at…