Industry Details Its Objections to ICER's Approach

If you wanted to get a sense of where industry objects to the Institute for Clinical and Economic Review’s methods, you could do worse than to check out a couple of pieces that have dropped in the past week or so. ICER asked for feedback on its framework for 2024. Industry delivered.

NPC outlined a comprehensive and thoughtful set of concerns in its formal comment to ICER, highlighting the areas where ICER is trying to reset the rules. Among the NPC arguments worth spotlighting:

• ICER’s push to use a “shared savings” approach undercounts cost-offsets generated by new therapies and erases the value delivered by certain treatments.

• ICER’s intention to try to lower “willingness to pay” assumptions would have the effect of making interventions look less cost-effective across the board.

• ICER’s narrow definition of value makes it harder to fully appreciate the full range of benefits that a given therapy might deliver.

The NPC letter was sober and constructive, though it feels unlikely that ICER will do much to accommodate the points raised.

In contrast, No Patients Left Behind distributed a bomb-throwing release that declared that the group would not be submitting comments to ICER and then detailing its issues with the group, going so far as to recommend that companies refuse to engage with ICER altogether. “Innovators should make their arguments at intellectual forums like the ones offered by ISPOR, not on ICER’s rigged stage,” NPLB’s Peter Kolchinsky said in the release.

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While we’re talking ICER, the group also announced that it’s launching a new review, assessing a novel schizophrenia treatment from Karuna Therapeutics. Should be an interesting one, given the complexity of accounting for both treatment benefits and side effects of existing medicines.

• Something is going down in China, where the government seems to be signaling that it might be backing off a tad from its hyper-aggressive approach to low prices. Reuters reported on a meeting between 12 companies and the country’s finance minister that promised "more development opportunities.” Dow Jones has a brief note, sourced to Citi analysts, that said “less aggressive price-cut plans” are being implemented. Hoping we get a better wrap that pulls all of this together.

• KFF Health News, which changed its name from Kaiser Health News when I wasn’t watching, is out with a great explainer/feature on “white bagging.” It probably lets hospitals off a little too easy, but it’s a solid read nonetheless.

• Sen. Bill Cassidy used STAT to publish a list of the Senate HELP committee’s accomplishments around drug pricing. But I was most struck by the fact that the piece’s lede centers on Gary Cooper, a very fine actor. He’s also a very fine actor who died more than 60 years ago, making me suspect that, perhaps, our elected representatives are slightly out of step with the average American.

• Humira biosimilars launched over the weekend. I talked about that at greater length over at LinkedIn, if you’re curious. But the upshot is that we’re still in the high-price, high-rebate era. Which surprises no one.

• Tomorrow is Leqembi Full Approval Day (pending FDA endorsement). That means that the medicine will become reimbursable by Medicare, though plenty of hurdles to access will remain.