Institute for Clinical and Economic Review Seeks to Enhance Healthcare Value


ICER estimates annual funding available to spend on new drugs divided by the number of expected FDA approvals.

The Institute for Clinical and Economic Review (ICER), a non-profit organization whose goal is to improve healthcare value, is making waves in the United States.

A study in American Health & Drug Benefits notes that ICER is the first major attempt to publicly provide comprehensive clinical and cost effective analyses of treatments, tests, and procedures.

The group is looking to engage the public in healthcare value by providing transparent and scientifically rigorous information on clinical treatments and the long-term benefits for patients. This includes incremental costs to gain those benefits and the short term economic impact on the healthcare system, the study found.

The ICER proposed budget impact threshold is above a drug or product that would likely significantly contribute to the excess growth in costs. The Emerging Therapy Assessment and Pricing program that looks to evaluate new pharmaceuticals was funded through a $5.2 million grant from the Laura and John Arnold Foundation.

The impact of reports released in late 2015 has put pressure on manufacturers when their drug prices are more costly than ICER’s threshold of value and affordability, according to the report.

In order to measure value, ICER creates analyses using modeling approaches that are similar to the UK’s National Institute for Health and Care Excellence. Measuring for affordability involves estimating the amount of money available to spend annually on new drugs and divides it by the number of expected FDA approvals.

The study noted, however, ICER takes into account certain drugs that target prevalent disease or have significant clinical benefits and require a greater share of funds. The affordability calculations are adjusted by setting the threshold at double the amount that was calculated.

Currently, ICER facilitates public discourse on their reports during 3 reginal forums, where the clinical and economic evidence is reviewed.

Although the Academy of Managed Care Pharmacy (AMCP) has supported a format that consists of formulary submissions similar to ICER’s assessments, they still lack in systematic approach for cost effective modeling, according to the study. ICER also calculates affordability, develops reports with limited input from drug manufacturers, and ensures that processes and reports are transparent to the public.

The study concluded that ICER’s approach has allowed them to become a new trusted source for information.

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