Daily Rise: ICER continues to put insurance company profits over patient health

ICER defends itself against accusations that it serves insurance companies

The Institute for Clinical and Economic Review, known simply as ICER, continues to put insurance company profits over patient health.

Of course, you’d never know it from the latest talking points pushed out by ICER’s PR professionals. Earlier this month, the organization shifted into full damage control mode by releasing a lengthy rebuttal against accusations that ICER puts insurance company profits over the best interests of patients.

Stat News reports that ICER’s image consultants have dropped its “conciliatory approach” and are now “more aggressive” in striking back against the growing criticism of ICER.

“The controversial organization released a manifesto on Tuesday that attempts to rebut its many critics, who have chastised ICER for purportedly having cozy relationships with insurers; failing to sufficiently take into account the views of patients; and not providing enough time for drug makers to respond to assessments, among other things,” Stat News reports.

Unsurprisingly, ICER’s manifesto fails to address the real concerns of patients. For example, why does ICER continue to value the life of a patient with multiple myeloma worth “as little as 3/5 of a year for a healthy person”?

Oops! ICER makes $7.1 billion dollar mistake in determining cost of treatment

ICER’s manifesto defending insurance companies comes within days of a damaging new report that exposes major flaws in how the organization calculates the value of life-saving treatments.

A new study by the Partnership for Health Analytics Research has found that ICER overestimated the cost of two treatments by $7.1 billion. The Institute for Clinical and Economic Review initially predicted that two PCSK9 inhibitors would cost $7.2 billion. The real cost: approximately $83 million.

In addition to ICER’s $7.1 billion dollar mistake, the organization also miscalculated the value of treatments for cancer, hepatitis C, obesity management, cystic fibrosis, heart failure, psoriasis and diabetes — with predictions that were, on average, 11 times more than actual sales.

“Overestimating drug costs by so much cannot lead to good decision making,” says Dr. Michael S. Broder, MD, President of the Partnership for Health Analytics Research. “In fact, it is likely that patients feel the negative effects of such predictions in the form of early access restrictions and higher copayments.”

ICER’s astronomical errors could have life-or-death consequences for patients. As our policy director and co-founder Jonathan Wilcox wrote earlier this year, “Promising and proven treatments are being pronounced as too expensive, even if doctors judge they can keep patients healthy and alive.”

Quote of the Day: Patients can’t trust bad data from ICER

“If we can’t trust ICER to present accurate data about the impact of drug spending on our economy or governent expenditures, can we trust it, as it wants us to do, to determine patient access to new medicines?”

— Robert Goldberg, vice president and co-founder of the Center for Medicine in the Public Interest, writing at DrugWonks.com on why ICER can’t be trusted.

Patients Aren’t Buying ICER’s Latest Spin

ICER’s more aggressive publicity campaign isn’t changing the opinion of patients.

That’s because ICER hasn’t addressed patients’ genuine concerns about the organization’s flawed methodology. ICER didn’t address the real concern expressed earlier this year by Donna Cryor, J.D., President & CEO of the Global Liver Institute, and a patient who suffers from an autoimmune liver disease.  She pointed out that ICER’s “methodology consistently misrepresents and excludes patient-centered evidence, patient-reported outcomes, and cost-offsets, perpetuating the myth of the average patient or standardized over personalized care.”

Patients groups, such as Patients Rising, have pleaded with ICER to invite patients into their process.

“Every patient advocate in the lung cancer community wants to help move towards more efficient, patient-focused care aimed at eliminating waste and fraud within each sector of the health care ecosystem,” Terry Wilcox, our co-founder and executive director, wrote in response to ICER’s Draft Scoping Document for Non-Small Cell Lung Cancer. “We hope that ICER will choose to genuinely and comprehensively reach out to the advocacy community for a robust exchange in search of ways to collaborate.”

Sadly, instead of patient engagement, ICER has embraced professional image consultants and their insurance company backers.

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