- The Institute for Clinical and Economic Review, a looked-to nonprofit group, plans to develop a subscription service for payers and pharmaceutical companies to more easily access and adapt its work on the cost and clinical effectiveness of new drugs.
- Drugmakers and insurers which subscribe would have access to two tools ICER is currently developing, one of which would allow outside groups to analyze and adjust the economic models used by ICER to determine a drug’s value and potential budget impact.
- ICER has steadily expanded the scope of its research work in recent years, in the process becoming a central player in the debate over what drugs should cost. While critics charge the group favors insurers and uses methods that don’t account for individual patient differences, ICER is one of only a handful of groups in the U.S. seeking to independently assess the economic trade-offs involved in the adoption of new therapies.
ICER’s latest move appears aimed at making its drug price analyses more indispensable to insurer and pharma decision-making.
Already, there are signs the group’s work is influencing how drugmakers think about pricing their products, and how insurers decide on coverage.
Last May, for example, Sanofi and Regeneron worked with ICER before making an offer to reduce the net price of the companies’ cholesterol drug Praluent (alirocumab) in line with estimates from the group of the treatment’s cost-effective price.
On the other side of drug price negotiations, CVS Caremark and the Department of Veteran Affairs’ pharmacy benefits office have both adopted ICER’s assessments into their processes for determining coverage.
Now, ICER is developing two tools that it hopes will help payers and drugmakers more easily incorporate the group’s work.
The first will compile ICER’s public evidence reports into a searchable and sortable database, with the aim of helping others develop templates to “guide pharmaceutical pricing strategies, payer benefit design, and the deliberations of Pharmacy & Therapeutics Committees,” ICER said.
ICER is also developing an “interactive modeler” that will allow outside groups to tailor models around patient sub-populations or different cost structures, for example.
The group said it would conduct interviews with potential users to help inform the final design of both tools, which it will describe in more detail closer to launch.
Last fall, ICER was reportedly considering offering a subscription service to drugmakers to help evaluate clinical trials before a new therapy was made commercially available.
Reports from ICER routinely find pharmaceuticals overpriced relative to their benefits, a track record that’s drawn criticism and pushback from industry, which argues the group’s methodology doesn’t always reflect the value treatment brings to patients.
In response, ICER has made its work more transparent, while defending use of metrics like quality-adjusted life years to gauge therapeutic cost effectiveness.
ICER is also working to update its value assessment framework and will accept comments and suggestions through June 10.
The group’s drug review work is funded by contributions from more than a dozen foundations and healthcare groups — most prominently a nearly $14 million grant from the Laura and John Arnold Foundation in October 2017.
Insurers and drugmakers also contribute financial support, but ICER claims that funding is used only for the group’s annual summit and other membership activities.