Trends in Icer Evaluations: A FIVE Year Longitudinal Analysis
Author(s)
Sander Kirschenbaum J1, Lodowski N2, White N1, Huang Y3
1PRMA Consulting, Philadelphia, PA, USA, 2PRMA Consulting, Jersey City, NJ, USA, 3PRMA Consulting, Fleet, UK
OBJECTIVES This research aimed to examine trends in ICER assessments over the past five years. METHODS Publicly available ICER reports were used to identify trends for pharmacologic final evidence reports, including 27 assessments from 2015-2020. We evaluated the assessments per year and therapeutic area, timing of assessments compared to FDA approval, and general cost-effectiveness conclusions. RESULTS The number of ICER evaluations completed have increased over time from 2015-2018, with over one-third (n=10) of the final evidence reports published in 2018 alone, however there was a drop to only 5 assessments completed in 2019. Nearly equal numbers of therapies were assessed 0-1 year after FDA approval (n=33), 1-5 years after FDA approval (n=28), and over 5 years after FDA approval (n=28). Only 17% (n=18) of therapies were assessed before FDA approval. Within the 27 reports reviewed, 45 indications were included and a total of 109 treatments were assessed. The reviewed therapeutic areas with the highest number of therapies assessed were CNS (n=32 therapies, 11 indications), inflammation/immunology (n=28 therapies, 4 indications) and oncology (n=23 therapies, 10 indications). Further, 33 treatments were found to be cost-effective under a $150k/QALY threshold. 73% (n=81) were not found to be cost-effective. 100% of the cardiovascular therapies assessed and 75% of the metabolic therapies were found to be cost-effective, while only 37% of inflammation/immunology, 28% of CNS, and 0% of endocrinology, rare-disease, psychiatry and respiratory therapies were found to be cost-effective. The remaining did not have cost-effectiveness ratios published. CONCLUSIONS Frequency of ICER assessments has increased over the years with a diversity of disease states assessed, the majority of which were found to be not cost-effective. Most ICER assessments are not conducted until post-product launch which decreases the value of assessments to US payers who might look to these reports to influence decision making.
Conference/Value in Health Info
2020-11, ISPOR Europe 2020, Milan, Italy
Value in Health, Volume 23, Issue S2 (December 2020)
Code
PMU67
Topic
Health Technology Assessment
Topic Subcategory
Decision & Deliberative Processes, Systems & Structure, Value Frameworks & Dossier Format
Disease
Multiple Diseases