Can ICER bring cost-effectiveness to drug prices?

Area of Science:

• Health economics
• Pharmaceutical policy
• Clinical evaluation

Background:

• Rising drug prices necessitate objective value assessments.
• Insurers and manufacturers seek reliable methods for drug price arbitration.
• The Institute for Clinical and Economic Review (ICER) has emerged as a key entity in this process.

Purpose of the Study:

• To examine the role of ICER in drug price determination.
• To investigate the methodologies employed by ICER, specifically its use of quality-adjusted life years (QALYs).
• To address the ongoing debate surrounding the cost-effectiveness calculations used by ICER.

Main Methods:

• Analysis of ICER's published reports and methodologies.
• Review of academic literature on health technology assessment and cost-effectiveness analysis.
• Examination of the role of QALYs in economic evaluations.

Main Results:

• ICER is frequently consulted by payers and manufacturers for drug value assessment.
• The reliance on QALYs in ICER's cost-effectiveness models is a point of contention.
• Concerns exist regarding the transparency and assumptions within ICER's calculations.

Conclusions:

• ICER plays a significant role in shaping drug pricing discussions.
• The validity and application of QALYs in ICER's assessments warrant further investigation.
• Continued scrutiny of ICER's methods is essential for ensuring fair drug pricing and value.