New Paper: Leading Health Economics Organization Overlooks Societal Value of New Drugs

The Institute for Clinical and Economic Review inconsistently applies its own criteria for incorporating societal perspective – undermining trust and undervaluing novel medications

WASHINGTON, June 1, 2023 /PRNewswire/ -- A new report from the Institute for Patient Access finds that the Institute for Clinical and Economic Review (ICER), the United States' predominant health technology assessment organization, frequently deviates from its own criteria by omitting societal perspective when assessing the value of new medications. The organization regularly undervalues new drugs as a result, calling into question how reliable and transparent its assessments are as a tool for decision-makers, including policymakers.

Societal perspective captures benefits of a new drug beyond the improved health of individual patients. It may include the value associated with alleviating caregivers' burdens, reducing health inequities or improving patients' ability to return to work. 

ICER incorporated criteria for using a societal perspective in the 2020-2023 iteration of its value assessment framework. Yet a review of 29 new drug assessments between 2020 and 2022, highlighted in IfPA's new paper, shows that the organization largely omits societal considerations from its assessments, even when its own criteria dictate otherwise. In 2020, only 18% of ICER's assessments included the societal perspective. In 2021, that number dropped to 10%.

The organization omitted the societal perspective from a number of assessments, including its evaluations of outpatient treatments for COVID-19, digital health technologies for treating opioid use disorder and novel medication for ulcerative colitis. In each case, the organization disregarded its own criteria.

Stakeholders, as well as ICER itself, have suggested that the government may use ICER's assessments as part of its new program to determine drug prices in the Medicare program. However, given the inconsistencies identified by IfPA's paper, ICER's assessments may not be a reliable source of information for policymakers, particularly given the purpose of the Medicare program.

STATEMENT FROM JOSIE COOPER, INTERIM EXECUTIVE DIRECTOR OF IFPA: "By bringing these inconsistencies to light, we hope that ICER will prioritize including the societal perspective in future assessments to more accurately account for the full value of innovative new medications to patients, caregivers and society."

The Institute for Patient Access is a physician-led policy research organization dedicated to maintaining the primacy of the physician-patient relationship in the provision of quality health care.

SOURCE Institute for Patient Access