ST. LOUIS--(BUSINESS WIRE)--The Center for Medicine in the Public Interest (CMPI) – a not-for-profit organization that advocates for consumer access to medical innovation – today challenged so-called value frameworks being proposed by the Boston-based Institute for Clinical and Economic Research (ICER). A white paper authored by Robert Goldberg, Ph.D, vice president and co-founder of CMPI, concludes that under ICER’s plan, 44,000 fewer patients with the cancer multiple myeloma will be alive within the next five years than if access to new medicines continues to grow at historical levels. At the same time, the CMPI report projects a serious drain on the U.S. economy from this loss of life, costing more than $12 billion in health expenditures and lost productivity.
The CMPI report, Not at Any Price: How ICER Robs Myeloma Patients of their Hope, challenges ICER’s assessment of the value of recently approved therapies for multiple myeloma, a rare cancer of cells in the bone marrow. ICER has also announced plans to conduct similar assessments of new treatments for lung cancer, multiple sclerosis and other serious diseases in the coming months.
“ICER states its goal is to ‘get excellent drugs to market as quickly as possible … and that will continue to spur innovation from manufacturers.’ However in reality, ICER’s proposed price cuts would eliminate 60 percent of new drug discovery,” said Dr. Goldberg. “ICER’s price recommendations won’t help patients, but they are designed to benefit insurers and pharmacy benefit management firms that fund the group.”
Based on a thorough review of ICER’s assessment and its calculations, the CMPI report questions ICER’s evaluation on a number of grounds. One major concern is that ICER applies a measure called the QALY, quality adjusted life year, to determine how much insurers and health systems should pay for additional years of life relatively free of disease. Therapeutics that exceed the QALY threshold are considered too expensive to be used unless prices are lowered.
“In practice, QALYs lead to rationing,” Dr. Goldberg stated. “Due to the reliance on QALYs, ICER ignores the value patients place on novel medicines that extend their lives when they are faced with certain death.”
Additionally, the report demonstrates how ICER uses partial data to overstate the expense of using new therapeutics while ignoring the rebates health plans and pharmaceutical benefit managers receive when they reduce access to these drugs.
Dr. Goldberg concludes, “Medically and economically we cannot base value on average patients. I personally know patients alive 10, 12, 15 years and longer while taking medications for multiple myeloma. They wouldn’t fit the ICER projections. To the contrary one reason for rising costs is that patients are living longer. That should always be our goal and not a problem.”