ICER Weekly View: May 3, 2019

From the desk of David Whitrap

While Chaucer thought April is sweet, Eliot argued that it may actually be the cruelest month. But wherever you stand on this literary divide, there’s no denying that, at least around here, this past April sure was wet. Rainiest April in Boston’s history, in fact. And as we turn the calendar to May, I say good riddance.

This morning, let’s take a look at:

  • ICER in the News: A look ahead to our 2020 Value Assessment Framework, our Evidence Report for secondary progressive MS, the draft scope of our Type 2 diabetes assessment, and one big misconception about US drug pricing.
  • Pharmaceutical News: The case for cost-effectiveness, Maryland’s plan to lower the cost of certain prescription drugs, an examination into how P&T committees operate, a movement to carve Medicaid out of the administration’s rebate ban, the pros and cons of including drugs’ list prices in TV ads, the legal troubles at Insys, and a health care system so convoluted that doctors can’t even figure it out.

ICER in the News

This week we announced the beginning of the process to update our value assessment framework for 2020 and beyond, and we called for public input on how we could enhance existing methods for how we evaluate prescription drugs and other health care interventions. Comments are welcome through June 10.

ICER Seeks Public Input for 2020 Value Assessment Framework

We also published our revised Evidence Report assessing the use of siponimod (Mayzent™, Novartis) for the treatment of all patients with secondary progressive multiple sclerosis. The Midwest CEPAC will deliberate on siponimod’s clinical effectiveness and other potential benefits during its May 23 public meeting.

ICER Publishes Evidence Report on the Use of Siponimod to Treat Secondary Progressive Multiple Sclerosis

Also this week, we posted our draft scope for our planned assessment of oral semaglutide (Novo Nordisk) and other treatments for Type 2 diabetes. The document is open to public comment through May 22.

ICER Posts Draft Scoping Document for the Assessment of Treatments for Type 2 Diabetes

As part of Business Insider’s ongoing series about the top 10 leaders transforming health care, the honorees were asked to identify the biggest misconceptions about the industry. From ICER’s President Steve Pearson: “It’s not just that the prices are too damn high, like the rent is too damn high. It’s really, we need a system that distinguishes when we’re getting good value, and the price at which it would be a fair value.”

10 leaders transforming healthcare shared the biggest misconceptions about their industry, from drug prices to psychedelics (Business Insider)

Pharmaceutical News

Dr. Arthur Garson writes for the Philadelphia Inquirer about how cost-effectiveness research is the key to aligning a drug’s price with how well it improves patients’ lives: “When a new drug comes along that’s more expensive than the current treatment, and doesn’t work much better, all of us — patients, policymakers, and medical professionals — should be skeptical.”

Here’s a simple way to reduce the price of prescription drugs: Pay for what works
(The Philadelphia Inquirer)

In Maryland, Governor Larry Hogan is poised to sign a bill that would create a panel to review expensive prescription drugs and potentially limit how much the state’s public agencies will pay for them.

Maryland Takes Step Toward Capping Drug Prices
(The Wall Street Journal)

Reuters takes a look at Pharmacy & Therapeutics committees, the independent panels that help insurers and PBMs determine formulary placement for prescription drugs.

The obscure advisory committees at the heart of the U.S. drug pricing debate

STAT reporter Nick Florko spoke to health policy experts inside and out of the pharmaceutical industry about the Trump Administration’s proposal to eliminate pharmaceutical rebates, and he found that “Nearly every major health care group, including the congressional Medicaid advisers known as MACPAC and even the NAACP have urged the Trump administration to carve out Medicaid from the proposal.”

Even many who support Trump’s drug rebate policy don’t support it in Medicaid
(STAT News)

Should drug prices be disclosed in TV ads? The Wall Street Journal published a point/counterpoint.

Should Drug Prices Be Disclosed in Ads Targeted Directly to Consumers?
(The Wall Street Journal)

A federal jury on Thursday found the top executives of Insys Therapeutics, a company that sold a fentanyl-based painkiller, guilty of criminal racketeering charges involving bribing doctors to prescribe dangerous opioids to patients who didn’t need them.

Top Executives of Insys, an Opioid Company, Found Guilty of Racketeering
(The New York Times)

And finally this week, I leave you with example #3,782 of the US health care system becoming too complicated. Judith Graham writes for Kaiser Health News about how even experienced physicians are flustered when placed in the position of a patient who needs to navigate through hospital and insurer bureaucracy.

Even Doctors Can’t Navigate Our ‘Broken Health Care System’
(Kaiser Health News)


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