ICER seeks to provide an independent source of evidence review—free from financial conflicts of interest—to help patients today and in the future by catalyzing a movement toward fair pricing, fair access, and future innovation across the entire US health care system. If you have a question that is not answered below, don’t hesitate to ask.

1. What is ICER? When was ICER founded? Learn more

Founded in 2006 as a research program at Harvard Medical School, ICER today is an independent non-profit research organization that evaluates the evidence on the clinical and economic value of prescription drugs, medical tests, devices, and health system delivery innovations. ICER engages with leading academic scholars and all key stakeholders—including patient groups, clinical experts, life science companies, and insurers—to inform its evidence reviews. All ICER reviews are transparent, rigorous, evidence-based, and available for free to the public. Following formal public comment and revision, each report is subject to public deliberation at meetings of independent appraisal committees, which include medical and patient experts. At these meetings, the “black box” of pricing and coverage is opened up, giving patients and the public a voice in framing the best way to translate evidence and patient perspectives into pricing and insurance coverage policies that will improve patient outcomes while controlling costs.

2. How is ICER funded? How does ICER’s funding keep its work free of conflicts of interest? Learn more

Funded by grants from non-profit foundations and other unbiased sources, ICER’s value assessments are free from financial conflicts of interest from life science companies and insurers. Given this unique position as an independent and unbiased source of information, ICER has become known as the nation’s drug pricing watchdog.

Life science companies and commercial payers participate in ICER’s Policy Leadership Forum, and their dues contribute to ICER’s annual Policy Summit, which convenes leaders from both industries to discuss broad initiatives that could help deliver fair pricing and fair access across the US pharmaceutical supply chain. In total, contributions from ICER’s Policy Leadership Forum represent less than 20% of ICER’s annual revenue.

Longer term, we anticipate that we will continue to diversify our funding through a mix of philanthropy, as well as research grants and contracts from foundations, federal and state governments, and public health systems.

For more information on our independent funding, click here.

For more information on conflicts of interest, click here.

3. How can I get connected with ICER’s work? Learn more

We work with a wide variety of stakeholders in the US healthcare system. From patient advocacy organizations to clinical experts to manufacturers, we want everyone to comment on ICER’s work so we can make it as relevant as possible.

To learn more about how you can engage with ICER:

4. Does ICER find all drugs to be overpriced? Learn more

No. When drug pricing reflects how well each drug improves patients’ lives, pharmaceutical companies that develop highly effective drugs will still be handsomely rewarded, and the US health system will still continue to incentivize the type of transformational pharmaceutical innovation we all want. The only difference is that Americans will stop paying far too much for the drugs that do far too little.

Across all the drugs ICER has assessed, more than 25% had a US price, net of rebates and discounts, that fell within ICER’s recommended health-benefit price benchmark (HBPB) range. Even Zolgensma®, which at $2.1 million represents the most expensive medicine currently available in the US, was deemed cost-effective by ICER because of its substantial clinical benefits. Treatments like Zolgensma – a potential cure for an almost always fatal childhood disease – are precisely the types of treatments the US health system should be incentivizing. However, the only way we can continue to afford to pay for breakthroughs like Zolgensma is if we stop overpaying for many other treatments that do not offer patients much benefit.

Email us at info@icer.org to learn about more case studies where the price aligned with the clinical benefit associated with that health intervention.

5. Can I nominate a topic for a future ICER review? Learn more

Yes.

For drug topics, in addition to receiving recommendations from the public, ICER scans publicly available information and also benefits from a collaboration with IPD Analytics, an independent organization that performs analyses of the emerging drug pipeline for a diverse group of industry stakeholders, including payers, pharmaceutical manufacturers, providers, and wholesalers. IPD provides a tailored report on the drug pipeline on a courtesy basis to ICER but does not prioritize topics for specific ICER assessments.

For non-drug topics, ICER takes recommendations from the public and also solicits suggestions from members of the Advisory Boards of our three independent appraisal committees (CTAF, Midwest CEPAC, and New England CEPAC).

To make a topic suggestion, fill out our topic suggestion form with your name, contact information, and brief description of the topic you would like to suggest.

 

 

6. Why does ICER review new medicines around the time of FDA approval? Learn more

ICER strives to complete most drug assessments around the time of FDA approval because this is when an independent assessment of value is most helpful in informing the critical decisions that stakeholders across the US health system need to make around pricing, coverage, and prescribing.

While it may seem premature to assess the value of a treatment before it has been given to a population in a real-world environment, this is precisely what pharmaceutical companies do when they set the treatment’s initial price.

As new evidence continues to emerge after FDA approval – either through post-marketing clinical trials or through real-world data collection – ICER will consider issuing a New Evidence Update to reflect the latest data, just as we have done for treatments like Praluent® and Veklury®.

To learn more about our methods & process, click here. 

7. How does ICER use the QALY to compare one medicine to another? Learn more

The quality-adjusted life year (QALY) is the gold standard for measuring how well all different kinds of medical treatments lengthen and/or improve patients’ lives, and therefore the metric has served as a fundamental component of cost-effectiveness analyses in the US and around the world for more than 30 years. If evidence shows that a treatment helps lengthen life, makes patients feel better, or reduces side effects, these benefits are comprehensively summed up to calculate how many additional QALYs the treatment provides, and this added health benefit is then compared to the added health benefit of other treatments for the same patient population.

ICER does not use the QALY to compare one person to another to recommend who receives treatment. That would be unethical and discriminatory. Instead, ICER uses the QALY to compare one medicine to another to see 1) which option is most effective, and 2) what a fair price would be for all patients who may be able to benefit.

To complement the use of the QALY, ICER’s reports also include a calculation of the Equal Value of Life Years Gained (evLYG), which evenly measures any gains in length of life, regardless of the treatment’s ability to improve patients’ quality of life. In other words, if a treatment adds a year of life to a vulnerable patient population – whether treating individuals with cancer, multiple sclerosis, diabetes, epilepsy, or a severe lifelong disability – that treatment will receive the same evLYGs as a different treatment that adds a year of life for healthier members of the community.

Coupled together, the QALY and the evLYG make what matters most to patients, count the most in determining the fairness of a drug’s price. They encourage drug makers and insurers provide better access to effective medicines we can all afford. And they enable policy makers to take a broader view of cost-effectiveness and be reassured that they are considering information that poses no risk of discrimination against any patient group.

Click here to learn more about ICER’s use of the QALY.

8. How does ICER address conflicts of interest? Learn more

Funded by grants from non-profit foundations and other unbiased sources, ICER’s value assessments are free from financial conflicts of interest from life science companies and insurers. ICER achieves additional transparency and objectivity by ensuring that every employee, academic collaborator, or member of an independent appraisal committee meets our established criteria to avoid any potential conflict of interest that may affect their judgment during an assessment. During our reviews, ICER welcomes participation from outside organizations and individuals that may have financial conflicts of interests – including pharmaceutical companies, patient advocacy organizations, clinical experts, and payers – but we require that those entities abide by our established policies for disclosing those potential conflicts.

For our complete policy on conflicts of interest for ICER staff and for external stakeholders, click here.

 

 

9. How do I stay updated on your current and future research? Learn more

ICER routinely issues press releases at the following phases during each assessment: topic announcement, draft evidence report, evidence report, and final evidence report.

ICER also issues a weekly newsletter that contains any important ICER updates. Click here to sign up.

You can also follow us on Twitter. 

10. Who uses ICER’s work? Learn more

Primarily, pharmaceutical companies and US payers use ICER’s reports as an independent input into their considerations around pricing and coverage. But increasingly, patient advocates, physicians, US legislators, and international health technology assessment organizations are also referencing ICER’s work to better understand how we all can better balance fair pricing and fair access.

While all of ICER’s reports remain in the public domain as downloadable PDFs from our website, ICER recently launched ICER Analytics™, a subscription-based tool that enables frequent users of ICER’s work to more easily customize and implement our findings.

Click here to learn more about our impact.