Value assessments like those imposed by the Institute for Clinical and Economic Review (ICER) could leave many patients without access to necessary medications if used as the basis of coverage, a recent study finds.
According to a recent article in PhRMA, one-size-fits-all value assessments won’t always work. If Medicare were to implement the framework in place at ICER, up to 93 percent of Medicare Part B patients with serious conditions such as Rheumatoid Arthritis and Multiple Sclerosis would lose access to their medications. PhRMA President and CEO Stephen J. Ubl called for more flexible value assessments that included “perspectives of what patients value.”
The study compared ICER’s assessments of “highest value” treatments to medicines used by Medicare Part B for MS and RA as well as non-small cell lung cancer and multiple myeloma. The study determined that of 200,000 beneficiaries, almost 140,000 could lose access to the treatments their doctors felt best for them under ICER standards.