Study Urges Caution Before Adopting ICER Reviews to Determine Cost Effectiveness of Treatments

Share on Facebook
Share on Twitter
Share on
LinkedIn
+

Review methodology could negatively impact elderly, the disabled, cancer patients and those with rare diseases

Media inquiries: Contact Micaela Dawson, 617-723-2277 ext. 203 or mdawson@pioneerinstitute.org

BOSTON – As states continue to grapple with prescription drug costs, a new Pioneer Institute study lays out the key ethical, methodological and disease-specific questions policy makers should address before deciding whether to contract with the Institute for Clinical and Economic Review (ICER) to conduct cost effectiveness reviews used to make decisions about the purchase of medicines and other medical innovations.

ICER utilizes Quality Adjusted Life Years (QALYs), a controversial evaluation technique that assigns an economic value to the longevity and quality of human life.

“The use of the QALY standard in the United Kingdom resulted in British cancer patients having some of the worst access to new cancer treatments in all of Europe and created a political crisis for British politicians,” said William Smith, author of “Key Questions for Legislators on the Institute for Clinical and Economic Review (ICER).” “U.S. politicians may want to proceed cautiously in adopting QALYs.”

QALY is controversial because of the impact that such a methodology may have upon access to medical innovations for older Americans, the disabled, patients with cancer and patients with rare diseases.

The National Health Service (NHS) in the United Kingdom utilizes QALY metrics.  But in the United States, the Affordable Care Act banned the use of QALYs for Medicare programs because of concerns about the impact upon older Americans, the disabled and the terminally ill.

Because of the vulnerability of these patient populations, Pioneer recommends that legislators avoid using ICER reviews until they are fully confident that the reviews will neither have an adverse impact upon these vulnerable populations nor discourage biopharmaceutical innovation for important unmet medical needs.

Download our one-page summary, Key Questions for Legislators.”

About the Author

William S. Smith is Visiting Fellow in Life Sciences at Pioneer Institute.  He has 25 years of experience in government and in corporate roles, including as vice president of public affairs and policy at Pfizer, and as a consultant to major pharmaceutical, biotechnology and medical device companies. He held senior staff positions for the Republican House leadership on Capitol Hill, the White House, and in the Massachusetts Governor’s office. He is affiliated as research fellow and managing director with the Center for the Study of Statesmanship at The Catholic University of America (CUA), where he earned his PhD.

About Pioneer

Pioneer Institute is an independent, non-partisan, privately funded research organization that seeks to improve the quality of life in Massachusetts through civic discourse and intellectually rigorous, data-driven public policy solutions based on free market principles, individual liberty and responsibility, and the ideal of effective, limited and accountable government.

Get Updates On Our Healthcare Research and Events!

Related Posts:

Public statement on new federal rule eliminating “skimming” of dues from caregivers’ Medicaid payments

Pioneer Institute applauds a new rule announced by the U.S. Centers…

Making Healthcare Prices Accessible

Today, Pioneer Institute filed a Public Comment with the federal…

U.S. HHS Secretary Alex Azar to Be Featured Speaker at Pioneer Institute’s 2019 Hewitt Healthcare Lecture

BOSTON – Secretary of the U.S. Department of Health and Human…

Study Finds Patient Cost for MRI Largely Unrelated to Overall Price or Insurer Contribution at 14 MA Hospitals

Read coverage of this report in WCVB-TV, Boston Herald, the Boston…

Study Urges Caution Before Adopting ICER Reviews to Determine Cost Effectiveness of Treatments

Review methodology could negatively impact elderly, the disabled,…

Study Finds MassHealth’s Enhanced Eligibility Verification Saves $250 Million a Year

Reforms fixed MassHealth's $1.2 billion eligibility crisis, freed…

Kudos To CHIA On Major Step Toward Greater Healthcare Price Transparency

Pioneer applauds the Center for Health Information and Analysis…

Report Recommends Alternatives to Drug Pricing Transparency Legislation

/
Value-based reimbursement, focus on middlemen in drug distribution…

MA Health Insurers Have Made Good Progress in Price Transparency, But Significant Work Remains

Read press coverage of this report in the Boston Business Journal and…

Study: Telemedicine Can Reduce Healthcare Costs, Improve Outcomes & Patient Satisfaction

Calls on Massachusetts to adopt telemedicine through the Group…

Pioneer Experts Offer Contrasting Prescriptions For MA Healthcare

BOSTON - New policy briefs from Josh Archambault and Barbara Anthony, two senior fellows in healthcare at Pioneer Institute, offer differing prescriptions for how Massachusetts should navigate uncertainty in the healthcare market, as Congress debates the fate of the federal Affordable Care Act (ACA).

Study Applauds State Decision To Let Healthcare Spending Benchmark Decrease

Calls on policy makers to continue pursuing efforts to trim healthcare…

Pioneer's 2017 Hewitt Lecture Highlights Innovations In The Massachusetts Healthcare Market

BOSTON - While efforts to revise the federal healthcare law continue,…

Follow-Up Survey Finds Hospitals Still Fall Short On Price Transparency

Estimated price of routine procedure at 21 Massachusetts hospitals…

Public Statement on the Recommendations of the Legislature’s Healthcare Provider Price Variation Commission

Commission Misses Great Opportunity to Advance Healthcare Price…

With Federal Health Law Facing Repeal, New Book Offers Alternative

U-Turn: America’s Return to State Healthcare Solutions (114…