ICER Considers Payers’ Drug Coverage in Fairness Assessment

The Institute for Clinical and Economic Review (ICER) has decided to expand its role to consider whether a health insurance plan provides adequate coverage for prescription drugs. It will determine the fairness of 15 major national payers in the United States in providing coverage for 28 drugs.

“The Institute for Clinical and Economic Review, known for its critiques of drug prices, is training its sights on health plan restrictions to medicines. “The national debate about drug pricing has focused great attention on methods to determine whether the price of a drug is ‘fair’ or ‘reasonable’,” ICER states in a summary of its work. “A question far less examined is how to determine whether insurance coverage is providing fair access to that drug.”’ Read more here.

(Source: John Wilkerson, Inside Health Policy, 6/3/21)