Research Type: Policy Paper

Unsupported Price Increases Occurring in 2023

Dec 2024 | Policy Paper

This initiative will identify the 10 net price increases occurring in 2023 that had the largest impact on national drug spending and determine whether new clinical evidence existed that could support those price increases. For questions or additional information, please contact info@icer.org.

ICER-PHTI Assessment Framework for Digital Health Technologies

Sep 2023 | Policy Paper

ICER and the Peterson Health Technology Institute (PHTI) collaborated on an assessment framework for digital health technologies (DHTs), which includes the conceptual model and associated methods that will guide assessments of DHTs within broader evaluative reports produced by the PHTI. Click here for the full framework. Date of publication: September 2023 For more information, please […]

Special Assessment to Inform CMS Drug Price Negotiation: Eliquis and Xarelto

Oct 2023 | Policy Paper

ICER is developing a special report evaluating the evidence on apixaban (Eliquis®, Bristol Myers Squibb) and rivaroxaban (Xarelto®, Bayer) for the treatment of nonvalvular atrial fibrillation (NVAF). ICER plans to release this report in September 2023 and submit it to the Centers for Medicare and Medicaid Services (CMS) as part of the public comment process […]

Methods Update: Value Assessment Framework

Sep 2023 | Policy Paper

The ICER value framework describes the conceptual framework and set of associated methods that guide the development of ICER evidence reports. ICER typically updates the value assessment framework once every three years. The purpose of the value framework is to form the backbone of rigorous, transparent evidence reports that, as a basis for broader stakeholder and […]

White Bagging, Brown Bagging, and Site of Service Policies

Apr 2023 | Policy Paper

The White Paper examines the efforts of payers to manage drug markups by implementing white bagging and brown bagging policies to shift the drug purchasing channel from providers to specialty pharmacies, as well as site of service policies requiring patients to receive treatment at lower-cost sites of care.  The Paper examines the existing evidence and […]

Fair Access: Coverage Policies in 2023

Nov 2023 | Policy Paper

ICER conducted our third annual assessment of how well major insurers’ prescription drug coverage policies align with a set of fair access standards developed by ICER with expert input from patient advocates, clinician specialty societies, US payers, pharmacy benefit managers, and life science companies. For each of the drugs reviewed by ICER in 2021 we […]

Unsupported Price Increases Occurring in 2022

Dec 2023 | Policy Paper

Of 10 high-expenditure drugs that had substantial 2022 net price increases, eight were not supported by new clinical evidence; these increases accounted for $1.27 billion in additional costs over one year. Separately, one of three Medicare Part B drugs with high list price increases in 2021 lacked adequate supporting new evidence, directly raising annual out-of-pocket expenses […]

Applying the Results of Comparative Effectiveness Research to Control Drug Costs: Policy Options for California

Mar 2023 | Policy Paper

This paper illustrates how comparative effectiveness research can be used by policymakers and health insurers in California to address rising drug costs by aligning spending with the degree of benefit a treatment provides.  ICER received a grant from the California Health Care Foundation (CHCF) to develop the White Paper. Date of publication: March 2023 For […]

Evaluating and Advancing Health Technology Assessment Methods that Support Health Equity

Mar 2023 | Policy Paper

ICER has received a new grant from The Commonwealth Fund to evaluate procedural and methodological changes that could further support health equity goals in health technology assessment (HTA). The findings from this effort will guide ICER’s update to its value assessment framework and inform the work of other HTA groups worldwide. Join us on March 21st for a webinar explaining […]

Fair Access: Coverage Policies in 2022

Jan 2023 | Policy Paper

While many key elements of fair access were not able to be assessed, the analysis found that major payer coverage policies for 19 drugs demonstrated high concordance with many fair access criteria related to cost sharing, clinical eligibility, step therapy, and provider restrictions.  During ICER’s assessment, five payers revised policies for 11 drugs in ways […]