ICER Weekly View: June 7, 2019

From the desk of David Whitrap

Good morning everyone. As I think about what the beaches of Normandy must’ve looked like 75 years ago, when the largest invasion against tyranny began the process of liberating Western Europe, I’m so, so grateful for those heroes who put the fate of the world ahead of their own lives.

While everything else seems insignificant in that context, we still need to carry on with our day-to-day. And for this modest newsletter, here’s what today’s day-to-day looks like:

  • ICER in the News: Our new assessment into acute migraine treatments; an update to the timeline for our “Valuing a Cure” initiative; this month’s cover article in Managed Care Magazine; the continued debate over a therapy’s $2.1 million price tag; and one more reminder about which direction US drug prices always seem to go.
  • Pharmaceutical News: The key takeaways from ASCO; the latest inside-the-Beltway machinations around drug pricing; an examination into what all these extra health care expenditures are actually buying; and why ending the AIDS epidemic now seems so possible, yet so far away.

ICER in the News

This morning, we announced we will begin an assessment of three investigational treatments for acute migraine: Biohaven’s rimegepant, Allergan’s ubrogepant, and Eli Lilly’s lasmiditan. We’re accepting Open Input from the public now through June 25.

ICER to Assess Treatments for Acute Migraine

We have an updated timeline for our “Valuing a Cure” initiative, and we now plan to post our white paper and draft methodology on August 6. The public comment period will occur from August 6 to September 6. We will finalize the white paper and methodology recommendations before the end of the year, and these recommendations, where appropriate, will be folded into our parallel initiative to update our 2020 Value Assessment Framework.

ICER Launches International Collaborative to Develop New Methods to Guide Value-Based Pricing of Potential Cures

The June cover article for Managed Care Magazine features ICER’s growing influence on US drug prices, highlighting multiple instances where fair pricing has led to fair access while sustaining sufficient incentives for future pharmaceutical innovation. Peter Neumann, director of the Center for the Evaluation of Value and Risk (CEVR) at Tufts Medical Center is quoted:

“ICER is responding to real needs in the marketplace, which is why they have become as visible as they have.”

Can ICER bring cost-effectiveness to drug prices?
(Managed Care Magazine)

On the heels of the FDA approval of the gene therapy Zolgensma, Bloomberg Businessweek published an article this week about how the US may struggle to afford and pay for cures. And over at Forbes, Joshua Cohen provided some helpful context for how to think about Zolgensma’s whopping $2.1 million price tag:

Too often the discussion of a drug’s price is fixated on eye-popping numbers and not value. It’s laudable that ICER redirected us to the discussion of value. In some instances, high prices may be justified by value; in others, not. At the same time, low-priced products may sometimes produce great value, and in other instances no value at all.”

Welcome to the Age of One-Shot Miracle Cures That Can Cost Millions
(Bloomberg Businessweek)

At Over $2 Million Zolgensma Is The World’s Most Expensive Therapy,
Yet Relatively Cost-Effective


Leaders from the Scripps Research Translational Institute authored an article in JAMA about how the prices of many of the most commonly used drugs continue to go up, up, up. In the concluding discussion about potential remedies, the researchers highlight the role ICER is beginning to play:

“Innovative solutions, such as the Institute for Clinical and Economic Review’s value-based price benchmark, have the potential to find appropriate price points for patients while rewarding drug manufacturers that produce transformative products.”

Trends in Prices of Popular Brand-Name Prescription Drugs in the US
(Journal of the American Medical Association)

Pharmaceutical News

At this week’s annual meeting for the American Society of Clinical Oncology (ASCO), a drug that can slow the progression of advanced breast cancer has been shown for the first time to lengthen survival in women whose disease started before or during menopause.

A Drug Prolonged Life in Younger Women With Advanced Breast Cancer
(The New York Times)

Also at ASCO, the FDA announced that the agency would become a middleman to help facilitate “compassionate use” access for gravely ill cancer patients seeking treatments that haven’t yet been approved.

US aims to help more cancer patients try experimental drugs
(The Associated Press)

In Washington DC, House Democratic leaders are facing skepticism from their progressive wing over a plan empowering the government to limit prices for some expensive prescription drugs.

Liberals fight their own party over drug prices

Meanwhile, Republican Senator Chuck Grassley outlined how to achieve bipartisan, bicameral support for a slate of policies aimed at lowering prescription drug prices.

Top Senate Republican outlines a path forward for bipartisan drug pricing bill
(STAT News)

A Los Angeles Times examination of job-based health insurance shows how the steep rise in deductibles, coupled with skyrocketing drug prices, has saddled insured, middle- and working-class Americans with medical bills they can’t afford.

Soaring insurance deductibles and high drug prices
hit sick Americans with a ‘double whammy’

(The Los Angeles Times)

To make matters worse, all those extra expenditures may not even be on high-value care. A pair of new studies sheds light on an old problem: Some medicines do not have evidence of efficacy, and some of these are even potentially harmful.

Too Many Medicines Simply Don’t Work
(Bloomberg Businessweek)

“The Daily,” the terrific podcast from The New York Times, this week reported on Truvada, Gilead Sciences’ once-daily pill that prevents HIV infection, and how the treatment’s $20,000-per-year price remains a major obstacle in ending the AIDS epidemic.

This Drug Could End H.I.V. Why Hasn’t It?
(The New York Times)

…And the patient community is taking action.

AIDS Activists Take Aim At Gilead To Lower Price Of HIV Drug PrEP


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