Innovation comes at a price, one that health insurers may hesitate to pay.
The Institute for Clinical and Economic Review finds new treatments for atopic dermatitis to be cost effective – justifying health plan coverage for the medications. But methodological missteps invite questions about how secure patients’ access to the treatments will be.
The Institute for Clinical and Economic Review has issued a draft report concluding that targeted immune modulators, such as biologic treatments, for rheumatoid arthritis are too expensive. The conclusion could embolden health plans to limit patient access.
But does ICER’s model accurately reflect the experiences of the 1.5 million Americans with rheumatoid arthritis?
Evaluating cost effectiveness is one thing; using value assessments to rank patients’ treatment options is quite another.
As ICER’s draft report acknowledges, plaque psoriasis is a common disease that can impact patients’ quality of life and daily functioning. With no cure available, patients have historically managed the condition with therapies such as methotrexate. Newer targeted and biologic therapies, however, can improve the duration and level of symptom relief that patients can achieve. […]
In light of the ICER value framework’s impact on health care, patients and physicians across the United States, we offer the following 12 suggestions for the updated framework to be implemented in 2017. These suggestions focus primarily on two areas for which ICER requested feedback: 1) Integration of patient and clinician perspectives on the value of interventions, and 2) Incremental cost-effectiveness ratios and thresholds.