ICER’s Annual Policy Summit: Fair Access

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ICER will wrap up our annual Policy Summit today, where leaders from pharmaceutical, payer, provider, and patient advocacy organizations gather to discuss collaborative opportunities to improve the US health care system. The focus of this year’s ICER Policy Summit was fair patient access to prescription drugs, and we are weighing all the thorny issues around cost-sharing, prior authorization protocols, step therapy, and more.

There’s an inescapable ethical tension at the heart of health insurance programs. On one hand, a noble aspect of our society is our willingness to pool financial resources to save and improve lives. And on the other hand, public and private payers have a responsibility to exercise prudent stewardship over these pooled, and ultimately limited, resources. As an output of this year’s Policy Summit, we’ll be publishing (in March-ish) a white paper that will address this ethical tension head-on, providing a detailed set of policy recommendations aimed at achieving fairer drug access across the US health system. Ideally, these guidelines will serve as a basis for establishing better coverage criteria, as well as a tool to hold payers accountable when they fail to provide appropriate access to high-value care. Stay tuned.