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ICER in the Time of COVID-19

Article

Like every other aspect of our lives, the COVID-19 pandemic has affected the clinical and cost-effectiveness research conducted by my organization, the Institute for Clinical and Economic Review (ICER).

Rest assured, ICER’s work continues. The FDA is still approving new medicines, and therefore our country still needs an independent voice to help determine what a fair US price may be for these new therapies. But since our drug reviews rely so much on expert input from clinical specialists and patient advocacy organizations - the very same people who need to be focusing all of their efforts on caring for their communities during the pandemic - we have extended the timelines on all going ICER assessments by up to three months.

ICER’s Public Meetings

In addition to providing a rigorous analysis of all the clinical evidence and contextual considerations surrounding a new medicine, perhaps the most important function ICER plays is to convene public meetings. Free and open to the public to attend, these meetings provide a venue where the evidence is presented and debated. Patients share their personal experience of living with the disease. Medical specialists describe the new therapy’s potential role within the current pharmaceutical armamentarium. All of the stakeholders - along with executives from biopharma and managed care organizations - discuss the policy implications of the evidence.

These public meetings don’t solve the inherent tensions within the U.S. health system - tensions around fair pricing, fair access, the need for future innovation, and gaps in evidence - but they do bring these backroom conversations out into the open, allowing patients to have a seat at the table. We often hear from insurers and PBMs that ICER’s public meetings can significantly influence the conversations that happen inside the meetings of their own P&T Committees.

So yes, we intend to proceed with our public meetings, although we recognize there’s a very good possibility that they will need to be conducted virtually until it is safer for us all to begin convening together in larger groups. They will continue to be broadcast live online as they always have, and highlights from our meetings will be embedded within ICER’s forthcoming Evidence Compendium and Interactive Modeler, a subscription-based suite of products tailored toward the managed care and pharmaceutical companies who seek easy and quick access to the conclusions of every ICER assessment.

Value assessments in a post-pandemic world

Moving forward, ICER’s goal will remain to enrich the objective analysis of clinical data with information and perspectives from patients, and to bring stakeholders together to drive progress in getting our health care system to be more effective and more affordable. The impact of COVID-19 will require that we, as a country, figure out how we can best care for patients and keep the entire health system and economy functioning. To that end, we need to stamp out price gouging and ensure that spending on existing drugs and other health services matches up fairly with their benefits. Every dollar spent where it does no benefit, or where it exceeds a fair market value for that benefit, is unacceptable.

Even while we are responding to this terrible pandemic, we still have a duty to marshal our resources so that we can do our best to provide care for patients across the entire spectrum of the health system. COVID-19 will test our resolve. It will test whether we can talk honestly about evidence, prices, and priorities. Clinicians, patients, the public, the life science industry, insurers, and the government - they all will need to step up. And so will we. ICER’s work continues.
 

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