 | More than 75 leading organizations representing patients, people with disabilities, and older Americans joined PIPC in submitting comments on the Institute for Clinical and Economic Review’s (ICER) proposed value assessment framework for 2024. |
The letter criticizes ICER for continuing to rely on metrics that devalue patients, as well as failing to advance simple actions that would meaningfully advance health equity. Moving forward, ICER should pursue incorporation of caregiver benefits and costs in future modeling but also go further and rely on the societal perspective for its base case models.
“While we share your interest in lowering health care spending and addressing affordability, ICER’s use of value assessments methods that discriminate and fail to accurately capture outcomes that matter to patients only emboldens payers to use utilization management tools restricting patient access, thereby limiting the ability of patients and their providers to make decisions about the best treatment path for them,” the letter states. “ICER’s value assessments do not promote affordability for patients, but instead give payers justification to create barriers to coverage of treatments that benefit their own bottom line.”
“While we share your interest in lowering health care spending and addressing affordability, ICER’s use of value assessments methods that discriminate and fail to accurately capture outcomes that matter to patients only emboldens payers to use utilization management tools restricting patient access, thereby limiting the ability of patients and their providers to make decisions about the best treatment path for them,” the letter states. “ICER’s value assessments do not promote affordability for patients, but instead give payers justification to create barriers to coverage of treatments that benefit their own bottom line.”
| icer_2023_framework_final_comment.pdf |
