Why is ICER Charging Ahead with Its Flawed “Shared Savings” Approach?

Today, the Institute for Clinical and Economic Review (ICER) released its revised evidence report assessing the comparative clinical effectiveness and the value of treatments for paroxysmal nocturnal hemoglobinuria. NPC is disappointed to see ICER charging ahead with moving the methodologic goalposts by incorporating its arbitrary (at best) and damaging (at worst) “shared savings” approach into this review. This is noteworthy because ICER is applying the shared savings approach in a “standard” review that was not subject to ICER’s single and short-term therapies adaptations.

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When CEA models assess drugs that provide enormous value to patients and society, there should be no surprise that value-based prices reflect that value.?ICER’s self-created shared savings approach is not evidence-based, lacks methodologic rigor, and operates in a false reality that does not reflect today’s marketplace. It was invented by ICER to justify artificially capping the recommended price when their cost-effectiveness analysis (CEA) calculates a price that is higher than ICER likes.??

ICER’s shared savings approach summarily ignores large chunks of drug value by throwing out most of the value due to cost offsets. This concept is not supported by any economic theory or practice and, moreover, is a willfully biased action that undercuts the objectivity and credibility of its assessments.? Worse, it clearly disincentivizes the development of new treatments that save lives and dollars. Readers interested in learning more about the shortcomings of this approach are encouraged to read NPC’s Health Affairs article, “Value Assessment’s “Leaky Bucket” Problem Needs To Be Addressed .”?

We strongly encourage ICER and other value assessors to embrace methodologic rigor and adhere to higher standards, as outlined in NPC’s newly updated Guiding Practices for Patient-Centered Value Assessment . Patients deserve better.