ICER Weekly View: June 14, 2019

From the desk of David Whitrap

Hello everyone. Across all four major US sports leagues, it’s been more than 25 years since a Canadian team captured a championship. Well, at least that was the case until last night when the Toronto Raptors won their first-ever NBA Finals. Separately, across all four major US sports leagues, no team has ever won a championship after sitting dead last in the standings with more than 25% of the games already played. Well, at least that was the case until Wednesday night when the St. Louis Blues accomplished that rags-to-riches feat in winning its first-ever NHL Stanley Cup.

I’m exhausted. #PlayGloria

This morning, let’s take a look at…

  • ICER in the News: A journal article proposing methods to pay for potential cures, and an editorial that dives into MassBio’s threats to leave Boston.
  • Pharmaceutical News: The leading DC ideas to improve drug prices (and why helping biosimilars isn’t among those ideas), which states aren’t waiting for federal action, and how much to read into a couple recent FDA decisions that sped products to market.

ICER in the News

ISPOR’s Value in Health journal published an article by ICER authors that explored several options for how the US health system can both reward and afford expensive therapies that may be potentially curative.

Determine Value-Based Prices for Potential Cures: What Are the Options?
(Value in Health)

Paul Hattis from Tufts Medical School authored an editorial in CommonWealth Magazine that poked holes in MassBio’s threats to flee the Boston area if MassHealth were to begin negotiating fair drug prices for Medicaid beneficiaries. Regarding ICER, Hattis writes:

“Perhaps $2.1 million, at the top of the range of ‘fair value’ per ICER analysis for [Zolgensma], can be defended for some period of time as a necessary cost to support medical care discovery for breakthrough treatments for rare diseases. That’s something we should all care about. Sadly, this Zolgensma example may be the exception rather than the rule. If you apply the ICER methodology to many other drugs paid for by our state Medicaid agency and private insurers, the dollars being handed over to pharmaceutical companies for medicines are well beyond their value point.”

MassBIO’s drug pricing concerns don’t add up
(CommonWealth Magazine)

Pharmaceutical News

Nick Florko from STAT News summarizes all the potential drug pricing legislation currently being discussed in DC, including one idea pushed by the pharmaceutical industry to cap Medicare Part D out-of-pocket costs.

How pharma could benefit from one of Congress’ signature drug pricing ideas
(STAT News)

Advocates say that they need lawmakers’ help soon, or else drugmakers will see biosimilars as a lost cause and the system will lose its only check on the cost of biologics. But Congress hasn’t demonstrated much urgency in helping the fledgling market for biosimilars.

Congress lukewarm on helping biosimilars

Floridians could eventually gain access to cheaper prescription drugs from Canada and other countries under legislation signed into law Tuesday by Gov. Ron DeSantis, if the federal government gives it a green light.

Florida governor signs bill for foreign drug importation
(The Associated Press)

On Tuesday, the Maine Senate unanimously passed four bills aimed at lowering prescription drug prices. One would set up a way for Mainers to buy lower cost drugs from Canada, another would protect consumers from unfair practices by pharmacy benefit managers, the third measure would set up a pharmacy board to judge the affordability of drugs, and a fourth would set up a wholesale importation process for drugs.

Maine Senate Passes Bills Aimed At Lowering Prescription Drug Prices
(Maine Public Radio)

U.S. Senator Bill Cassidy (R-LA) authored an editorial about various options to pay for potentially curative drugs. It’s worth noting that ICER’s proposed methods on assessing the value of these sorts of treatments will be published later this year.

How will we pay for the coming generation of potentially curative gene therapies?
(STAT News)

The next chapter in an unusual saga involving a high-priced, rare disease drug will play out in a federal court, where Catalyst Pharmaceuticals has accused the Food and Drug Administration of violating the law when it recently approved a similar medicine made by a small, family-run company.

Catalyst sues FDA over rivals’ drug approval,
warning it undermines incentives for rare disease meds

(STAT News)

Kaiser Health News published an investigation that uses the newly approved depression treatment Spravato as an example of how certain drugmakers are taking advantage of shortcuts in the FDA process to successfully maneuver through safety and efficacy reviews to bring lucrative drugs to market.

FDA Overlooked Red Flags In Drugmaker’s Testing of New Depression Medicine
(Kaiser Health News)

And finally this week, I humbly submit this heartbreaking news clip from Salt Lake City as rationale for why ICER is needed…

Police: Man says he robbed bank because he couldn’t buy meds
(The Associated Press)


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