ICER addresses misconceptions about value assessment goals and methods
The Institute for Clinical and Economic Review (ICER) has released a new publication to support the ongoing public conversation about its goals and the methods for evaluating the value of new drugs, devices, and other health system innovations. This publication, “Addressing the Myths About ICER and Value Assessment,” answers questions about ICER’s history, mission and methods while addressing misperceptions that may impede the kind of collaboration that is at the heart of ICER’s work.
“We know that any effort to develop independent evaluations of the value of new tests and treatments raises questions about how the evidence is interpreted, and how the results may be used,” said ICER’s Founder and President Steven Pearson, M.D., MSc. “That’s why ICER strives to ensure that all stakeholders in the health care system—patients, manufacturers, payers, clinicians and others—have an opportunity to contribute meaningfully to our work. We are particularly concerned that patients and patient groups understand how important their role is in guiding the way we prioritize evidence and present the broader view of value in our assessment reports on drugs and other health care services.”
Some common myths, explained in the publication, are based on misperceptions about ICER’s founding, its funding sources, and concerns that ICER does not appropriately account for patients’ views in assessing value. The publication clarifies that since its origin as an academic research group at Harvard Medical School in 2006, ICER has reached out to listen to all stakeholders as it develops independent reports summarizing the evidence on what works best for different kinds of patients. ICER reports also tackle the important question of how different treatment options compare on cost, both over the short-term and long-term. However, the publication describes how ICER’s value assessment is not intended to support the rationing of care; the ultimate goal has always been to help patients, clinicians, manufacturers, payers, and policymakers work together so that cost and insurance coverage are aligned to make sure that patients are able to access—and afford—the most effective treatments for them.
“For decades, I’ve pushed for better (not just more) drugs at reasonable prices and better clinical trial methods to produce results that answer real-world patient needs,” said Deborah Collyar, founder and president of Patient Advocates in Research (PAIR). “The evidence to help patients and clinicians compare different treatment options can sometimes be quite thin. Meanwhile, recent trends in drug pricing have increased pressure to limit access to many new treatments. ICER has a proven willingness to take on these tough issues directly. After volunteering on ICER’s CTAF advisory board and attending many of their public meetings in person, I’ve yet to witness a negative impact on patient access and care. Instead, I continually see open conversations between different stakeholders. These occur despite preconceived expectations, and involve expansive thinking on ways to improve the value of patient care rather than a narrow focus on pricing.”
As ICER’s work has become better known, questions have arisen about its intentions, methods, and ultimate impact. Some of the concern has been principled and thoughtful, reflecting different views on procedural and methodological aspects of ICER’s reports. This input has always been welcomed and encouraged; in fact, ICER has made numerous changes over the years to address issues raised. Unfortunately, some recent criticism has been fueled by a lack of knowledge about ICER or even purposeful misinformation by a few vocal critics who oppose a move toward pricing that is better aligned with the added value a drug, device or treatment provides to patients.
ICER is an independent nonprofit research institute that produces reports analyzing the evidence on the effectiveness and value of drugs and other medical services. ICER’s reports include evidence-based calculations of prices for new drugs that accurately reflect the degree of improvement expected in long-term patient outcomes, while also highlighting price levels that might contribute to unaffordable short-term cost growth for the overall health care system.
ICER’s reports incorporate extensive input from all stakeholders and are the subject of public hearings through three core programs: the California Technology Assessment Forum (CTAF), the Midwest Comparative Effectiveness Public Advisory Council (Midwest CEPAC) and the New England Comparative Effectiveness Public Advisory Council (New England CEPAC). These independent panels review ICER’s reports at public meetings to deliberate on the evidence and develop recommendations for how patients, clinicians, insurers, and policymakers can improve the quality and value of health care.