The Impact PCSK9 Inhibitor Pricing had on Payers, ICER

April 15, 2021
Briana Contreras

Peter Wehrwein

In this second part of a three-part series, Steven D. Pearson, M.D., M.Sc., founder and president of ICER addresses if pricing of PCSK9 inhibitors put ICER on the map.

Below is a short Q&A excerpt of an interview with Steven Pearson of ICER. Text has been edited for length and clarity.

Q: Did the pricing of the PCSK9 inhibitors put ICER on the map?

A: Well, we have been in existence already for almost seven, eight years at that stage and so if there had already been notice to our work, especially around the time of the new, big budget-buster drug for hepatitis C that was on people's radars, it helped bring more attention. Not too long after the hepatitis C drugs came the PCSK9 inhibitors, and what was unique about them was that they were a completely new paradigm of care for patients with high cholesterol.

Related: ICER Chief on Bempedoic Acid and Inclisiran: Don’t Repeat the PCSK9 Mistake

There are obviously a lot of patients in the country who have high cholesterol in spite using the available pills. The potential for the budget impact was so high that it raised people's attention. So our approach is not to worry so much about the short-term budget impact but to really try to capture the long-term value in the way that we look at value. Even looking at the PCSK9 data at the time of its launch, we did take the list price that they came out was far too high to match up with what was going to be the likely clinical impact, because remember, by that point we didn't even have the clinical trials that said it did prevent heart attacks and strokes. We just had trials that showed it lowered cholesterol.

So taking that on, we did a model that said connecting to the likely downstream reduction in heart attacks and strokes, how valuable would these be and what would a fair price be so when we came out with a much lower price, it affirmed what many payers and others were feeling - which was that this seemed like an expensive drug for the for the clinical value, that it was going to provide for the average patient for every patient, but for the average patient.