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CAR-T Cancer Drugs Get Nod of Approval from ICER

Innovative but expensive CAR-T therapies for cancer are worth their price, announced the Institute for Clinical and Economic Review recently.  The organization is the self-appointed arbiter of drug costs.  But its decision was hardly news for those in the cancer community.

Two CAR-T therapies have been approved in the United States ― one for certain children and young adults with a specific form of leukemia, and the other for certain adult patients with aggressive B-cell non-Hodgkin lymphoma. CAR-T therapies are a form of immuno-oncology that involves removing a patient’s immune cells, equipping them with cancer-fighting properties, and returning them to the patient’s body.   

The therapies have proven effective for patients who don’t respond to first-line treatments.  Cancer experts hail CAR-T as a major innovation, the biggest oncology breakthrough of 2017.  So ICER’s lukewarm acknowledgment that “These therapies seem to be priced in alignment with clinical benefits over a lifetime time horizon,” was welcome, if somewhat redundant.  

Using its hallmark cost-effectiveness framework, ICER determined that these therapies fall within the organization’s long-term cost-effectiveness range and below its overall budget impact threshold.  The two drugs’ wholesale acquisition costs are estimated at $373,000 and $475,000.

Acknowledging the value of medical innovation is something of a rarity for ICER.  On the heels of its CAR-T analysis, the organization dismissed the first-ever cure for genetic childhood blindness last week as too expensive.  ICER suggested reducing the drug’s price by about 75 percent, an unlikely discount.  ICER has suggested similar price slashing in recent months for innovative treatments for the movement disorder tardive dyskinesia and for drugs that treat a form of eczema known as atopic dermatitis.

ICER’s analyses can inform health plan design, potentially undermining coverage for innovative drugs that don’t conform to ICER’s price thresholds.  So while the organization may seek to humble pharmaceutical companies, it can instead hurt patients – including those who desperately want breakthrough medicine.

The public comment period for ICER’s draft evidence report on CAR-T therapies closes January 24.

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