WASHINGTON – Today, the non-profit Institute for Patient Access made the following statement regarding the Institute for Clinical and Economic Review’s (ICER) draft evidence report on the value of new, innovative treatments for migraine known as CGRP inhibitors.
ICER’s draft evidence report, released on Wednesday night, acknowledges that CGRP inhibitors are “projected to have positive impact” on quality of life and the number of migraine days experienced by patients. But while the drugs “may” stay within the threshold for a subgroup of patients, the report explains, they will “likely exceed” ICER’s price threshold for patients with episodic migraine or patients with chronic migraine who have other treatment options.
ICER estimates that its annual budget threshold would allow for as little as 16 percent of eligible migraine patients to be treated with a CGRP inhibitor.
Clinicians, advocates and patients view these new migraine treatments as life-changing because there are very few therapies to treat this chronic, disabling condition.
Migraine disproportionately affects women and, in recent years, has emerged as a common problem for veterans, particularly for those who have been deployed.
Last fall, the Institute for Patient Access submitted comments urging ICER to incorporate in its report effective estimates for all of the potential benefits associated with more effective treatment of migraine, which include: reduced health care costs associated with treating migraine headaches, reduced health care costs associated with treating the comorbid conditions, increased worker productivity, increased quality of life for patients, increased quality of life for family members or other caregivers, and the potential reduction in costs associated with the opioid abuse crisis. In ICER’s subsequent draft scoping document, these concerns were not addressed.
STATEMENT FROM BRIAN KENNEDY, EXECUTIVE DIRECTOR, INSTITUTE FOR PATIENT ACCESS:
“ICER’s draft report is, unfortunately, exactly what the Institute for Patient Access expected. It reduces the value of life-changing therapies to an exercise in economic number crunching using the QALY, a metric with significant and documented shortcomings. It trivializes the variability among migraine patients, their comorbidities, their specific headache disorders, and their responsiveness to both existing and forthcoming therapies.
Finally, it lays the predicate for insurance companies to deny access to groundbreaking CGRP inhibitors, effectively ensuring that this ‘invisible disease’ will continue to debilitate patients.”