The Institute for Clinical and Economic Review (ICER) wields considerable influence over drug prices by providing analysis of a medicine’s fair market value to payers. Since 2015, the organization has examined nearly 100 drugs to determine if they are cost-effective based on their benefit to patient quality of life over one year. Of these, ICER found only 1/3rd were cost-effective.
As evidence mounted that remdesivir was helping COVID-19 patients, some investors bet that its maker, Gilead, would charge exorbitant prices for the drug—in some cases up to $10,000. ICER on the other hand, said the treatment only justified a price between $2,800 and $5,000. This illustrates the growing power of ICER to exert downward pressure on drug prices.
The industry has aggressively moved to counter the threat to its profits by openly criticizing ICER’s formula and with an underhanded, stealthy campaign to undermine ICER’s credibility through proxies such as the Partnership to Improve Patient Care (PIPC) and Value our Health. Sara van Geertruyden, executive director of PIPC blasted ICER as a “payer-focused” organization delivering skewed assessments that allow insurers to deny patients access to drugs. “Is it any surprise patients would be concerned?” she asked.
Houston billionaire John Arnold, the main funder of ICER said, “The status quo works very well in the industry, so it is important for them to label any proposed reform as something radical and something that won’t work,” he said. “There is not much debate about whether the system we have to price pharmaceutical drugs is broken.” Read the full story here.
(Source: Caroline Hunter, Reuters, Sep 11, 2020)