Do Research Groups Align on the Value of an Intervention? A Prelude to our ISPOR Barcelona Presentation
By Matthew Sussman
ISPOR Europe 2018 in Barcelona is sure to be an exciting conference! I expect there to be lively discussions, during both the plenary and breakout sessions, on the fairness of pharmaceutical pricing, the appropriateness of implementing budget-capping strategies to health policies, and the future of QALYs. Following the conference, it will be fun to perform mental gymnastics to consider how these concepts will migrate from the European to the US healthcare system.
I am also looking forward to contributing to these lively discussions by presenting on the concordance of cost-effectiveness (CE) findings between the Institute for Clinical and Economic Review (ICER) and other health system stakeholders, including life science manufacturers, academia, and government institutions.
ICER’s Guiding Principles
ICER utilizes its updated Value Assessment Framework to determine a drug’s short-term affordability as well as its long-term value for money. The basis of ICER’s method is CE modeling, which merges clinical effectiveness and comparative effectiveness analyses in order to provide guidance on an intervention’s long-term value for money. In its framework, ICER commits to a fixed and pre-defined CE threshold of $50,000 to $175,000 per QALY gained (USD) which impacts the recommendation for or against an intervention. ICER does not recommend interventions with incremental CE ratios above $175,000 per QALY gained, which are deemed low value for money.
What is the Rationale for the Presentation?
Given national scrutiny on rising drug prices in the US, ICER’s CE findings are primed to impact formulary decision-making processes. In addition to ICER’s publicly-disseminated CE analyses, life science manufacturers, academia, and government institutions also conduct and publish their own CE analyses of interventions. The burning question that then remains: is there alignment on CE findings between ICER and other research groups?
Key Questions Determined through Our Research:
Through our research, we were able to answer the following questions:
- Do ICER’s CE findings differ from those of other industry stakeholders?
- Are ICER’s CE ratios higher or lower than the CE ratios determined by other industry groups?
- What is the magnitude of the differences in CE ratios?
- Would the differences lead to an alternative determination of the value of the intervention?
Presentation Details
If you are attending ISPOR Barcelona, please stop by my poster presentation to discuss our findings! Below are the presentation details:
Poster Title:
Do All Research Groups Align on the Value of an Intervention? Concordance of Cost-Effectiveness Findings between ICER Reports and Other Publications
Research Poster Presentation:
Session III
PHP: Health Care Use & Policy Studies
Date and Time:
Tuesday, November 13, 2018
Display Hours: 08:45 - 13:30
Poster Author Discussion Hour: 12:30 - 13:30