Institute for Clinical and Economic Review

The Institute for Clinical and Economic Review (ICER) is a Boston-based independent nonprofit organization that seeks to improve healthcare value by providing comprehensive clinical and cost-effectiveness analyses of treatments, tests, and procedures.[1]

It was founded in about 2005 by physician-researcher Steven D. Pearson, MD, MSc, FRCP.[1] Until 2014 it concentrated on assessing health care costs (rather than evaluating drugs).[2] It evaluates the cost effectiveness of drugs in a similar way to the UK's NICE,[1][3] and has come under some criticism from the drug industry.[2] It has issued a number of drug evaluations since 2014.[2] especially since July 2015.[4] The institution is funded by the Laura and John Arnold Foundation, drug makers, insurers, and government grants.[5]

Threshold cost criteria

ICER estimates the amount of money available to be spent annually on new drugs and then divides that amount by the number of expected US Food and Drug Administration approvals to set an affordability benchmark.[1]

ICER's affordability calculations adjust for drugs targeting prevalent diseases and/or those presenting a significant clinical benefit by setting the threshold at double the available funds divided by the expected number of new drugs (approved by FDA).[1][2]

After discussions in 2016 ICER broadened its quality-adjusted life year threshold to $50,000 - $150,000.[6]

Drugs evaluated - reports issued

It issued a draft report that said Sovaldi wasn’t worth the list price of about $84,000 a year.[2]

As of May 2016 ICER published final reports on

- Multiple myeloma - Palliative care[7]

It has criticised the high price of drugs for osteoporosis, multiple sclerosis, PCSK9 cholesterol meds, and immuno-oncology therapies.[6][8]

In 2017 it issued a controversial draft report on PARP inhibitors for ovarian cancer.[6]

Drug evaluations planned

A preliminary list of drugs to be evaluated includes rociletinib, AZD-9291, necitumumab, nivolumab, and pembrolizumab for small-cell lung cancer; fingolimod, dimethyl fumarate, teriflunomide, alemtuzumab, and daclizumab for multiple sclerosis; and ixekizumab and brodalumab for psoriasis or psoriatic arthritis.[1]

See also

References

  1. 1 2 3 4 5 6 Pizzi, LT. "The Institute for Clinical and Economic Review and Its Growing Influence on the US Healthcare". Am Health Drug Benefits. 9: 9–10. PMC 4822973. PMID 27066190.
  2. 1 2 3 4 5 This nonprofit is playing a valuable role in framing the drug price discussion. Silverman. April 2016
  3. ↑ Institute for Clinical and Economic Review Seeks to Enhance Healthcare Value.
  4. ↑ Series of reports will analyze cost, benefit of pricey drugs
  5. ↑ https://www.statnews.com/pharmalot/2016/04/12/drug-prices-icer/
  6. 1 2 3 Cancer-fighting PARP drugs from AstraZeneca, Clovis and Tesaro largely overpriced, watchdog says. July 2017
  7. ↑ http://icer-review.org/materials/
  8. ↑ Are new bone drugs from Amgen and Radius cost-effective? Not even close, ICER says. May 2017


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