Drug Cost-Effectiveness Assessments Require Standards for Rigor and Inclusion

Area of Science:

• Health economics
• Pharmaceutical policy
• Health services research

Background:

• The Institute for Clinical and Economic Review (ICER) is a key independent assessor of drug prices in the U.S.
• ICER's cost-effectiveness assessments influence health insurance coverage and healthcare policy.
• Current ICER methodologies may lack rigorous data quality and inclusion criteria.

Purpose of the Study:

• To evaluate the methodologies used by ICER for cost-effectiveness assessments.
• To identify areas for improvement in ICER's data quality and assessment standards.
• To advocate for changes that enhance the rigor and inclusiveness of drug price evaluations.

Main Methods:

• Critical analysis of ICER's current practices in cost-effectiveness modeling.
• Review of data quality and inclusion criteria applied by ICER.
• Examination of outcome measures used in ICER assessments, such as quality-adjusted life-years.

Main Results:

• ICER's assessments may be compromised by suboptimal assumptions and data inputs.
• The reliance on certain effectiveness measures may not fully capture drug value.
• Lack of standardized data quality benchmarks can lead to inconsistent evaluations.

Conclusions:

• ICER should adopt minimum standards for data quality and inclusiveness.
• Re-evaluation of outcome measures like quality-adjusted life-years is recommended.
• Enhanced rigor in assessments will promote fair drug pricing and access to effective care.