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Updated: Jun 11, 2025

Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
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Will the Institute for Clinical and Economic Review's Shared Savings Approach Decrease Value-Based Prices Most for

Jason Shafrin1, Shanshan Wang2, Khounish Sharma1

  • 1Center for Healthcare Economics and Policy, FTI Consulting, Los Angeles, CA, USA.

Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research
|October 2, 2024
PubMed
Summary
This summary is machine-generated.

The Institute for Clinical and Economic Review's (ICER) shared savings assumptions disproportionately impact rare, severe, and pediatric diseases. These assumptions may negatively affect health-benefit price benchmarks for conditions with significant economic burdens.

Keywords:
ICERrare diseaseshared savings

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Area of Science:

  • Health Economics
  • Pharmacoeconomics
  • Clinical Trial Analysis

Background:

  • The Institute for Clinical and Economic Review (ICER) utilizes shared savings assumptions in its health technology assessments.
  • Understanding the impact of these assumptions on different disease categories is crucial for accurate value-based pricing.
  • Recent FDA approvals offer a dataset to evaluate ICER's methodology on novel therapies.

Purpose of the Study:

  • To identify disease types most susceptible to the influence of ICER's shared savings assumptions.
  • To analyze how ICER's shared savings methodology (50/50 and $150,000 cost-offset cap) affects the valuation of hypothetical cures.
  • To determine characteristics of diseases most impacted by these economic models.

Main Methods:

  • Extracted economic burden and disease characteristics for treatments approved by the FDA between 2019-2023.
  • Applied ICER's 50/50 shared savings and $150,000 cost-offset cap methodologies.
  • Evaluated the difference in eligible cost savings for a hypothetical cure under both methods.
  • Descriptively analyzed disease characteristics associated with the greatest impact.

Main Results:

  • Shared savings significantly reduced the value of hypothetical cures for hemophilia A, acute hepatic porphyria, and paroxysmal nocturnal hemoglobinuria.
  • Diseases with higher annual burdens (≥$150,000) exhibited earlier onset, lower life expectancy, and reduced prevalence compared to those with lower burdens.
  • ICER's shared savings had a greater projected impact on health-benefit price benchmarks for diseases with shorter life expectancy, worse quality of life, and lower prevalence.

Conclusions:

  • ICER's shared savings assumptions are projected to have the most substantial negative impact on health-benefit price benchmarks for rare, severe, and pediatric diseases.
  • These findings highlight potential disparities in how novel therapies for specific disease populations are valued.
  • Further research may be needed to refine economic models for equitable valuation across diverse disease types.