CVS Caremark is set to implement a new strategy that could deliver a blow to drugmakers’ pricing power, according to a Fierce Pharma report.
The pharmacy benefit manager is planning to let clients cite drug review assessments by the Institute of Clinical and Economic Review to exclude drugs.
The PBM in a white paper writes clients will be able to exclude drugs with a quality-adjusted life years number — provided by ICER — higher than $100,000. Critics, according to the report, say payers could use the data to restrict patient access.
Pharmaceutical companies are likely to oppose the program, but ICER Communications Vice President David Whitrap tells Fierce Pharma the organization is “encouraged” by widespread use of its work.
“The ideal result of any health benefit design is for patients to have access to all high-value treatments, and for pharmaceutical innovation to be fairly rewarded,” he said. “By using independent evaluations to link price more closely to the added clinical benefits a drug provides, drug makers and payers both can take action to accelerate the transition to a health system that achieves these goals.”
To read the full report on Fierce Pharma, click here.