Ongoing Assessments & Recent Research.
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Institute for Clinical and Economic Review Publishes Fourth Annual Assessment of Barriers to Fair Access Within US Commercial Insurance Prescription Drug Coverage
Most payers evaluated offer fair access across the domains reviewed; findings underscore the need for greater transparency of coverage policy information for patients.
12/19/2024Institute for Clinical and Economic Review Publishes Final Evidence Report on Treatment for Epstein-Barr Virus Positive Post-Transplant Lymphoproliferative Disease
Independent appraisal committee voted that current evidence is adequate to demonstrate superior net health benefits for tabelecleucel when compared to usual care; tabelecleucel would achieve common thresholds for cost-effectiveness if priced between $143,900 to $273,700 per treatment cycle.
12/16/2024Institute for Clinical and Economic Review Announces Most Significant Drug-Price Hikes Unsupported by New Clinical Evidence in US
Of 10 high-expenditure drugs that had substantial 2023 net price increases, five were not supported by new clinical evidence; these increases accounted for $815 million in additional costs over one year.
12/12/2024Our Origin Story.
Dr. Steve Pearson explains why he founded an organization to advance the use of evidence to improve health care affordability and access for all patients and their families.
The ICER Impact.
New York Medicaid pursued discounts, many of which were in line with ICER reports, which have saved the state over $500 million
Engaged with over 400 patient groups and patient reps
In a landmark international program, HTA agencies around the world can now access ICER’s customizable COVID-19 Cost-Effectiveness Model
Key
Developments.
The ICER-developed Clinical trial Diversity Rating (CDR) Tool presents a framework for evaluating the demographic diversity of clinical trial populations in a consistent, transparent manner leading to an overall diversity rating. Learn more.
In early 2024, NICE announced a collaboration with ICER, CADTH, and ZIN (also known as the National Healthcare Institute in the Netherlands) to share learnings about the development of economic models at the disease level (rather than product level). Learn more about the initiative here.
The ICER Patient Council recently met in person to discuss ICER’s patient engagement activities over the last year and to make an action plan for the next 12 months. One output of that meeting was the ICER Patient Council Progress Report, which describes the various projects the Council has reviewed and advised to enhance ICER’s Patient Engagement Program.
Current
Policy Papers.
Easy access to our latest policy papers
Barriers to Fair Access
ICER’s fourth annual “Barriers to Fair Access” assessment of prescription drug coverage policies within US commercial insurance, and the Veterans Health Administration. The analysis found that major payer coverage policies for 11 drugs often met fair access criteria for cost sharing, clinical eligibility, step therapy, and provider restrictions.
However, the report’s findings suggest that major improvements are needed in the transparency of coverage policy information for consumers, and in detailing out-of-pocket costs for patients.
Unsupported Price Increases
Of 10 high-expenditure drugs that had substantial 2023 net price increases, five were not supported by new clinical evidence; these increases accounted for $815 million in additional costs in 2023.The five drugs with unsupported price increases are Biktarvy, Darzalex, Entresto, Cabometyx, and Xeljanz.
Managing the Challenges of Paying for Gene Therapy
An analysis of policy reforms and market actions to support innovation and access while managing uncertainty, affordability, and equity concerns; developed as part of ICER’s Policy Leadership Forum with input from diverse stakeholders.