ICER Weekly View: May 24, 2019

From the desk of David Whitrap

Good morning everyone. The St. Louis Blues are the oldest active NHL team never to have won the Stanley Cup, but they’ve finally made it back to the finals thanks in no small part to Laura Branigan’s 1982 pop song “Gloria.” And you thought US drug pricing was irrational.

This morning, we’ll take a look at:

  • ICER in the News: New cloud-based tools that will accelerate the use of ICER’s assessments in the US health system; our draft evidence report on treatments for Duchenne muscular dystrophy; and awaiting the launch of a gene therapy that’s estimated to cost somewhere between $1M-$5M.
  • Pharmaceutical News: The latest DC drug pricing news from the Senate, House, and CMS; one insulin starts selling at half-price, while Colorado takes a step to limit copays on ALL insulins; and the realization that the US isn’t the only country worried about drug prices.

Here we go…

ICER in the News

At this week’s annual ISPOR meeting, ICER announced plans to develop two new tools that will enable decision-makers across the health care system to easily integrate ICER-generated analyses and curated content into their formulary process, benefit design, and/or pricing strategy. The entirety of each individual ICER assessment will remain in the public domain and free for anyone to access, but the new tools will make the entire body of ICER work easier to search, analyze, and apply to a wide variety of decision-making platforms.

ICER Plans Cloud-Based Tools to Accelerate the Use of Value Assessments in the US Health System

On Wednesday, we released a Draft Evidence Report assessing the clinical effectiveness and value of two gene therapies to treat Duchenne muscular dystrophy (DMD) — eteplirsen (Exondys 51®, Sarepta) and golodirsen (Sarepta) — as well as deflazacort (Emflaza®, PTC Therapeutics), a corticosteroid. Public comment is open now through June 18.

Watchdog group says there’s little evidence to show
Sarepta’s muscular dystrophy drugs work

(The Boston Globe)

Debate erupts over whether Sarepta’s rare disease drug
has enough clinical data to determine cost-effectiveness

(STAT News)

Want bang for your buck? Don’t look to Sarepta’s pricey DMD therapy Exondys, ICER says (FiercePharma)

Sarepta’s Exondys 51 is not cost-effective,
nor particularly beneficial for DMD patients — ICER

(Endpoints News)

In anticipation of the potential FDA approval of Zolgensma, a gene therapy to treat spinal muscular atrophy, several media outlets are noting ICER’s assessment.

Novartis head coy about pricing on breakthrough drug
(The Boston Globe)

New gene therapy drug expected to hit market with head-spinning price tag

Pharmaceutical News

Many expected a new draft proposal in the Senate to focus more on surprise medical bills than on drug pricing, but its policies toward PBMs are surprisingly ambitious.

A new Senate health package includes surprisingly aggressive drug pricing reforms
(STAT News)

Seven pieces of drug price legislation, all of which are bipartisan, were on the slate for discussion at the House Energy and Commerce Committee Subcommittee on Health hearing on Tuesday.

Industry experts weigh in on slew of bills
aimed at drug price transparency at hearing 


CMS Administrator Seema Verma said Wednesday there need to be “serious discussions” on how to pay for new and extremely pricey drug innovations, and she floated the idea of outcome-based payments for drug therapies, where insurers and patients would pay for treatments that work and potentially get a rebate if it fails.

Verma exploring outcome-based ideas to tackle high drug costs
(Modern Healthcare)

A half-price version of Eli Lilly’s popular Humalog insulin is now available, following the company’s promise in March to offer patients a more affordable option amid fierce criticism of soaring insulin prices.

Lilly selling half-price version of popular Humalog insulin
(The Associated Press)

Colorado Gov. Jared Polis signed a bill into law Wednesday that places a $100 per month cap on insulin co-pays, regardless of how much insulin a patient uses. The plan sponsor will pay the rest.

Colorado is the first state to cap skyrocketing insulin co-pays

And finally, The Economist’s Natasha Loder makes the case that the US isn’t the only country worried over high drug prices. (It’s just that the other countries seem to be more willing to do something about it.)

The global battle over high drug prices
(The Economist)


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