— Expanded funding supports the development of two annual “Unsupported Price Increase” reports specific to drugs identified through the California drug price transparency law —
— ICER will also produce a guide for California policymakers on how to use comparative effectiveness reports to negotiate better prices with drug manufacturers, move to evidence-based formularies, and ensure fair access through appropriate insurance coverage criteria —
BOSTON, March 3, 2022 – The Institute for Clinical and Economic Review (ICER) has received a new grant from the California Health Care Foundation (CHCF) to develop 1) two annual unsupported price increase reports specific to California, and 2) a policymaker guide outlining how to use comparative effectiveness research to ensure that patients have fair access to fairly priced drugs.
Additionally, the CHCF grant will continue to fund ICER value assessments evaluated by the California Technology Assessment Forum (CTAF), an independent appraisal council for ICER.
CHCF is dedicated to advancing meaningful, measurable improvements in the way the health care delivery system provides care to the people of California, particularly those with low incomes and those whose needs are not well served by the status quo.
“For nine years, funding from CHCF has allowed ICER to lead a national discussion about how to align the prices in our health care system with the benefits patients receive from various treatments, therapies, and interventions. Policymakers are now regularly referencing ICER’s health-benefit price benchmarks when crafting legislation to address rising US health care costs, especially around prescription drug spending,” said Sarah K. Emond, MPP, ICER’s Executive Vice President and Chief Operating Officer. “Building on our long partnership with CHCF, we are focusing on creating tools specific to California decisionmakers. These new reports, along with all of our value-based assessments, will continue to move the country toward a more transparent health care system that rewards medical innovation while also allowing patients to access the treatments they need.”
California passed SB-17, a drug transparency law requiring manufacturers to report increases to prescription drugs’ wholesale acquisition cost (WAC). ICER will leverage the annual SB-17 reports on brand and specialty drugs with the most significant year-over-year spending increases to evaluate whether there is new evidence that could justify the price increase (using the same methodology used for our annual unsupported price increase report at the national level).
Policymakers in Hawaii, Maine, and Washington have recently considered penalizing drug makers for price hikes that are unsupported by clinical evidence and redirect money from the fines to consumer financial assistance.
The new grant funding will also provide support for ICER’s policy implementation work through the creation and publication of guides for policymakers, purchasers, and other decisionmakers in California looking for ways to leverage independent value assessment for improved access and affordability for patients.
The Institute for Clinical and Economic Review (ICER) is an independent non-profit research institute that produces reports analyzing the evidence on the effectiveness and value of drugs and other medical services. ICER’s reports include evidence-based calculations of prices for new drugs that accurately reflect the degree of improvement expected in long-term patient outcomes, while also highlighting price levels that might contribute to unaffordable short-term cost growth for the overall health care system.