Will the Biden administration set up an ICER-like Drug Affordability Commission?

March 3, 2021
Peter Wehrwein

Harvard drug policy experts say in an opinion piece in JAMA that a drug affordability commission might be one of several ways that the new administration deals with prescription drug prices.

How and when (and if) the Biden administration might deal with drug pricing is impossible to say at this point, but three drug policy and pricing experts at Harvard Medical School say the new administration may consider establishing some kind of drug affordability commission.

“The Biden administration could also plan to establish a Drug Affordability

Commission to review the clinical benefits of high-cost drugs and publish voluntary recommendations for negotiated,” wrote Aaron Kesselheim, M.D., J.D., M.P.H., Thomas J. Hwang, and Jerry Avorn, M.D, in today’s JAMA. They are affiliated with the Program on Regulation, Therapeutics, and Law at Harvard-affiliated Brigham and Women’s Hospital.

It is no coincidence that the putative commission sounds like the Institute for Clinical and Economic Review (ICER). Kesselheim, Hwang and Avorn say in their JAMA piece that if the Biden administration were to create such a commission, it “might build” on the work of ICER.

Kesselheim and his colleagues also say in their JAMA opinion piece that the Biden administration will have to decide what to do about the flurry of drug-pricing rules issued by the Trump administration in its waning days, including one that would peg Part B drug prices to those paid by governments in similar countries (known as the most favored nation rule) and another one dealing with rebates for Part D drugs.

ICER isn't the only model for judging drug prices and effectiveness. Kesselheim, Hwang and Avorn referred to healthcare technology assessment organizations in Canada, Germany and the United Kingdom. Also, in the absence of a federal body, several state have gone ahead and established their own drug affordability boards or commissions. A report by Manatt Health in October 2020 says six states had passed legislation setting up drug affordability bodies; Kesselheim, Hwang and Avorn identify them as New York, Massachusetts, Maine, Maryland, New Hampshire and Ohio.

Biden’s nominee for CMS administrator, Chiquita Brooks-LaSure, is a managing director at Manatt Health.