ICER Weekly View: June 21, 2019

From the desk of David Whitrap

Good morning everyone. Busy week, so let’s get right into the news coverage:

  • ICER in the News: The Boston Globe’s front-page profile of ICER’s growing influence, and our Final Evidence Reports on both Spravato (for treatment-resistant depression) and Mayzent (for secondary progressive multiple sclerosis).
  • Pharmaceutical News: Recapping all the latest drug-pricing debates within the House, Senate, and Administration; Amazon fires another shot across the bow of PBMs; and a reminder why politicians should stop guaranteeing cures for cancer.

ICER in the News

The front page of yesterday’s Boston Globe took a deep dive into ICER’s growing influence in how pharmaceutical companies price their drugs. In doing so, the article displays all the tensions inherent in trying to assess the value of treatments in the US. ICER’s President Dr. Steve Pearson summarizes the position we find ourselves in:

“We’re not here to tell the pharmaceutical industry that they’re evil. We’re not here to tell the payers that they’re evil. We’re here to find the win-win by providing an independent look at the evidence.”

Boston drug pricing watchdog group is ‘mouse that roared’
(The Boston Globe)

We published our Final Evidence Report on Spravato (esketamine) for treatment-resistant depression. Esketamine’s list price would require a 25-52% discount to reach a fair value-based price benchmark, and the potential short-term budget impact associated with treating the eligible patient population led ICER to issue an Access and Affordability Alert.

ICER Issues Final Report and Policy Recommendations
on Esketamine for Treatment-Resistant Depression

Also yesterday, we published our Final Evidence Report on Mayzent (siponimod) for secondary progressive MS. At our public meeting, the expert roundtable discussion highlighted siponimod’s evidence limitations, its similarity to fingolimod, and its high price — suggesting that siponimod does not merit a unique role in therapy.

ICER Issues Final Report and Policy Recommendations
on Siponimod for Secondary Progressive Multiple Sclerosis

Our review of siponimod was reported on by Reuters early this morning.

U.S. group says Novartis MS drug price out of line with benefit

Pharmaceutical News

A blog post for The Commonwealth Fund explores how drug prices are negotiated in Germany. After briefly describing ICER’s work in the US, the authors conclude with key lessons our country can take away from the German experience:

“Success for a drug-purchasing system would include three features: a transparent and evidence-based approach to evaluating the clinical value of each new treatment; an affordable set of prices linked to clinical value; and a recognition by both buyers and sellers that the process is fair, financially sustainable, and supportive of continued investments in pharmaceutical innovation.”

How Drug Prices Are Negotiated in Germany
(The Commonwealth Fund)

Bringing the focus back to the US, Katie Thomas at The New York Times provides an overview all the various Congressional proposals to lower drug costs, and she identifies where there may be bipartisan common ground, and where there likely won’t.

Drug Prices Are a Populist Campaign Issue.
Here Are the Latest Proposals to Lower Costs.

(The New York Times)

Reducing prescription drug prices was a key plank of House Democrats’ platform during the 2018 midterms. More than six months into their term, however, a concrete bill has yet to emerge from House leadership on the subject, and early excerpts Speaker Nancy Pelosi has floated have spurred progressive concern.

House Democrats’ internal feud over prescription drug prices, explained

US Senators Lamar Alexander and Patty Murray introduced a major health care package Tuesday aimed at drug pricing, including language that aims to prevent spread pricing and ensure timely access to generic drugs.

Senate committee to vote on health package
with ambitious plan to reduce drug prices

(STAT News)

Next Monday, President Trump plans to call for insurers and doctors to disclose new details about the cost of care, a move that industry groups have resisted.

Trump to Issue Executive Order on Health-Care Price Transparency
(The Wall Street Journal)

Meanwhile, Republican Senator Chuck Grassley told reporters on Wednesday that he opposes the Trump Administration’s plan to peg US drug prices to what’s paid in other countries – otherwise known as the “International Pricing Index.”

Grassley announces opposition to key Trump proposal to lower drug prices
(The Hill)

Amazon is seeking to contract directly with health plans and employers to sell prescription drugs through its PillPack subsidiary, a move that would cut out existing pharmacy benefit managers and potentially reshape the sale and distribution of medicines in the US, according to newly surfaced court documents.

Amazon looking to work directly with health plans and employers
to sell prescription drugs, court documents say

(STAT News)

And finally this week, both President Donald Trump and former Vice President Joe Biden have said in recent days that if they’re president, they will cure cancer. Although the pledges may seem like any other campaign trail boast, experts say it can give the public false hope that hurts the path toward cures in the long run.

Trump vows to cure cancer and eradicate AIDS
as he kicks off reelection campaign

(CBS News)


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