ICER’s Faux Updates

Hannah Wolf  0:03  
Welcome to Healthcare Policy pop. I'm Hannah Wolf. It's Thursday, October 5 2023. Today's pop topics, more organizations are weighing in on the ICER updates to measurement assessments we told you about last week. The update, which patients rising now calls a faux update because there wasn't much updating at all, is getting reactions from many affected parties. Today, John O'Brien, President and CEO of the National pharmaceutical Council is also weighing in.

John O'Brien  0:38  
So when I first saw this, it made me remember that NPC looks at value assessment and HTAs with an appreciation of the fact that it's comprised of both science and opinion. So this update is no exception. And there's definitely a great deal that remains opinion and incomplete. And the reason that's concerning to me is it research says that the use of value assessments like these are on the rise. So it's really important to patients and the scientists that work and health economics and outcomes research to make sure that folks like ICER or don't build frameworks the wrong way.

Hannah Wolf  1:16  
Brian, like many says the issues began even before the update was released. 

John O'Brien  1:22  
You know, there are a lot of concerns with the update itself. But let's zoom out for a minute and talk about what I think are some real process files that had an impact on patient input. First, they removed the Open Input period, and then they shortened the public comment period from 58 days to 25 days. Now, perhaps as a result, the number of commenting patient advocacy organizations plummeted from about 20 to eight. 

Hannah Wolf  1:51  
O'Brien and the National pharmaceutical council have three main issues with the update. Number one

John O'Brien  1:57  
ICER doesn't include what we refer to as a societal perspective, and its base case for all assessments, despite best practices, saying you should and organizations across the board saying they should do so. So ICER missed a real opportunity to broadly measure and value treatments.

Hannah Wolf  2:17  
Second, ICER isn't accounting for changing prices. 

John O'Brien  2:21  
ICER failed to incorporate dynamic pricing within this update, again, despite many organizations saying they should do so. Here's what that means. When ICER does a value assessment, they assume that payers are going to pay the launch price forever. We all know these prices and reality come down. So NPC and others are going to continue to advance research that demonstrates that if you don't include the dynamic nature of a drugs price, you underestimate its value.

Hannah Wolf  2:52  
Finally, the lack of consideration for something O'Brien considers critical is also concerning.

John O'Brien  2:59  
Despite other assessment organizations moving towards quantifying and weighing what I like to refer to as the novel elements of value like severity ICER has at best postponed including these these elements within its price opinion algorithms. And at worst, they're just not going to recognize their importance and their value.

Hannah Wolf  3:19  
We have a link to the National Pharmaceutical Council's full statement in the show notes.

Hannah Wolf  3:30  
The American Enterprise Institute has released its perspective on last year's inflation Reduction Act and what it actually means for patients and physicians. The AE article outlines priorities for leaders who aim to further value based care. That story is in the shownotes. Finally, today, some patient news that deserves recognition. The National Institute on Minority Health and Health Disparities has now officially designated people with disabilities as a quote, population with health disparities. The designation could help with research funding and resources. That's all for today. We're back on Tuesday for another health care policy pop, a resource of patients rising now. I'm Hannah Wolf, have a great day.