ICER Update 02.27.20

Hello, everyone, and welcome to this week’s edition of Excelsior Solutions’ ICER Update.
Here is this week’s ICER recap:

  1. ICER released a Draft Evidence Report for cystic fibrosis (CF) therapies Trikafta, Symdeko, Orkambi, and Kalydeco. This preliminary draft marks the midpoint of ICER’s eight-month process of assessing these treatments, and the findings within this document should not be interpreted to be ICER’s final conclusions. Public comments are due on March 18, 2020.
    EXCELSIOR ACTION POINT: Since there is some overlap among these products in terms of the appropriate genetic profile suitable for each treatment, along with the fact that CF constitutes a material portion of drug spend in plans that have members with CF, ICER’s work in this disease category is welcome and timely. We encourage you to participate by accepting ICER’s invitation to submit public comments based on your plan’s experience.
  2. ICER also announced this week that it will assess the comparative clinical effectiveness and value of nadofaragene firadenovec (Instiladrin) for bladder cancer. They are accepting Open Input until March 10.
    EXCELSIOR ACTION POINT: This is an uncharacteristically narrowly focused assessment by ICER of one drug, one that will not be reviewed for approval by the FDA until mid-2020, in a disease category having limited treatment options. I am surprised by the limited scope of this effort.
  3. Finally, ICER announced plans to assess the comparative clinical effectiveness and economic value of two different non-drug topics: digital apps for opioid use disorder and supervised injection facilities (SIFs). Along with past ICER assessments of related topics such as abuse-deterrent opioid formulations, medication-assisted treatment for opioid use disorder, and non-drug interventions for lower back pain, the announcement reinforced ICER’s commitment to provide an independent evaluation of the evidence around interventions that target the public health crises stemming from the opioid epidemic in the United States. ICER is now accepting Open Input on their assessment of digital apps through March 10, and on their assessment for the SIFs through May 14.
    EXCELSIOR ACTION POINT: I included this item in the update for two reasons: (a) Because it supports our belief that effectively dealing with the opioid crisis will require more than simply limiting the number of units of opioids dispensed per Rx, and (b) To illustrate the multi-disciplinary scope of the ICER organization. I hope that you find it interesting.

As always, if you would like to discuss the potential impact of these, or any prior, ICER reports, or any other aspects of your Pharmacy Benefit Plan, simply reach out to your Excelsior Solutions account team and we will be happy to quickly set up a call.

Until next time!
Bob Kordella, RPh, MBA

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