Membership

Logo-membership hi res

The Institute for Clinical and Economic Review (ICER) launched a membership program in 2015 to give a select number of leading health care organizations a unique opportunity to shape the future of evidence and coverage policy in the U.S.  The tension between innovation and health care costs continues to focus critical attention on how evidence will be developed by manufacturers and how it will be interpreted by payers in making coverage decisions.  Benefiting from ICER’s experience as a leader in health technology assessment, and its unique ability to serve as an engaged, objective convener and moderator, ICER membership brings together a small, influential group of evidence leaders from insurers, pharmacy benefit management firms, health technology assessment groups, and life science companies to address key controversies in evidence methods and policy.  Working together in a balanced, non-adversarial environment, ICER members gain the skills and insights in evidence policy necessary to strengthen their competitive position in the marketplace.  The Membership Year runs from July 1st – June 30th.


White Papers

Each year, ICER convenes a Policy Summit for ICER Members to bring together an influential group of evidence policy leaders from insurers, pharmacy benefit management firms, and life science companies to explore new challenges and opportunities in the health care system. Following that meeting, ICER produces a white paper detailing key findings from the discussion. Importantly, no assertion, judgment, or recommendation included in the white papers should be viewed as representing the opinion of any participant or their company; ICER is ultimately responsible for the final content. ICER’s white papers from 2016 and 2017 are below:


Standard Membership Benefits

  • Policy Summit participation. ICER members receive an invitation for 2 staff to participate in an annual ICER Policy Summit. Based on the model of the influential international Health Technology Assessment International (HTAi) Policy Forum, this meeting convenes no more than 25-40 senior medical policy figures from leading insurers, pharmacy benefit management firms, and the life science industry to consider important issues related to comparative effectiveness research, technology assessment, coverage decision-making, and health care financing. The results of the meeting are developed into a journal article to be submitted for peer-reviewed publication.
  • Evidence Dialogues. An invitation for an unlimited number of company staff to join at no cost two special ICER “evidence dialogue” policy webinars each year. These webinars feature moderated discussion among 2-3 HTA/payers and 1-2 life science companies on approaches to determining the value of specific types of emerging therapies. These insights ate linked to considerations of options for coverage and payment policy and to the focus and design of future research studies. The topics for these webinars are selected with input from the membership.

Flagship Membership Benefits

A limited number of Flagship ICER memberships will be available. ICER Flagship Members will receive all the benefits of Standard ICER membership plus:

  • A seat on the ICER Policy Summit Steering Committee that will select the topics for the Policy Summit
  • An additional invitation for a seat at the annual ICER Policy Summit
  • A position on the ICER Advisory Board which meets annually with ICER’s Governing Board to provide guidance on ICER’s overall portfolio of activities and strategic plan
  • A seat on the Methods Advisory Board that holds quarterly calls to provide guidance on the methods to evaluate comparative clinical effectiveness and value used by ICER in reports developed for its most influential public programs
  • An annual all-day, on-site consultation from senior ICER staff at a time of the company’s choosing

What ICER Membership Can Bring to Your Organization (Life Science Industry)
From the structured interactions with key policy leaders from the payer community, life science companies who become ICER members will gain the ability to:

  • Design clinical research studies that will meet the evidence standards of both public and private insurers
  • Contribute to a shared understanding of the evidence standards that US payers will use in making coverage determinations for different classes of new therapies
  • Contribute to collaborative development of new ways to link coverage and evidence development that reflect the rapid innovation in medical science
  • Explore best practices and suggest new approaches to harmonize evidence standards across regulatory and coverage bodies

What ICER Membership Can Bring to Your Organization (Health Insurance Industry)
From these structured interactions, insurers, pharmacy benefit managers, and risk-bearing provider groups who become ICER members will gain the ability to:

  • Anticipate emerging tests and therapies and understand how to adopt best practices for the evaluation of the evidence on these new interventions
  • Contribute to a shared understanding with other stakeholders about what represents “adequate” evidence for emerging tests and treatments, contributing to less contentious coverage decisions
  • Understand novel approaches to evaluate the economic impact of new interventions and to build assessments of “value” into innovative benefit designs and coverage policies
  • Contribute to collaborative development of new ways to link coverage and evidence development that reflect the rapid innovation in medical science

Additional Benefits of ICER Flagship Membership
ICER Flagship Members will also gain the ability to:

  • Help pick the topics for the ICER Policy Summit and recommend specific content experts for speaking roles in each meeting
  • Guide the evolution of the methods of ICER’s most influential public evidence review programs, CTAF and CEPAC, which have gained widespread followings among payers and which continue to pioneer new ways to assess the value of health care interventions and suggest value-based pricing policy options
  • Get in-person consultations from ICER staff to help bring into your organization high-level perspectives on comparative effectiveness research and value assessment
  • Contribute to the guidance of ICER’s overall strategic orientation going forward

Membership Activities and Compliance/Integrity

  • ICER Members have no role in influencing the selection of topics for ICER evidence reviews.
  • Flagship members with a position on ICER’s Advisory Board will be able to provide perspective and advice to ICER on how it can best fulfill its mission but the Advisory Board has no direct governance role.
  • During all discussions at ICER Policy Summits and Advisory Board meetings, ICER staff and Advisory Board members will refrain from any discussion that could provide the basis for an inference that members considered any action that might restrain trade in any way.
  • The aim of ICER Policy Summit meetings is to provide an environment where senior policy leaders can engage in strategic discussions informed by the perspectives of their different organizations without the constraints associated with discussions of specific products or organizational policies. At no time, therefore, will these meetings include discussion of the competitive merits of any specific technology. Case studies regarding questions of evidence and coverage will be framed to avoid any competitive repercussions. ICER members are encouraged to express any concern that a competitive issue has arisen, at which time discussion of that topic will cease until all parties are comfortable with the line of discussion.

Current Members

Aetna
AHIP
Anthem
AstraZeneca
Blue Shield of CA
CVS Caremark
Express Scripts
Genentech
GlaxoSmithKline
Harvard Pilgrim Health Care
Health Care Service Corporation (HCSC)
Johnson & Johnson
Kaiser Permanente
Merck
National Pharmaceutical Council
OmedaRx
Premera
Prime Therapeutics
Sanofi
Spark Therapeutics
United Healthcare

For more information on becoming a member, please contact Bill Dreitlein, ICER’s Director of Pharmaceutical Policy.