NOTE: Since today’s update was written, ICER has announced either the indefinite postponement (Sickle Cell Disease, Cystic Fibrosis) or 2 to 3 month delay (NASH, Ulcerative Colitis, Bladder Cancer, Digital Apps for Opioid Use Disorder, and Hemophilia A) in all of its pending work, so this update will likely be the last that we will create and push out for the foreseeable future.
Hello, everyone, and welcome to this week’s edition of Excelsior Solutions’ ICER Update.
Here is this week’s ICER recap:
ICER published an Evidence Report assessing the comparative clinical effectiveness and value of treatments for sickle cell disease: crizanlizumab, voxelotor, and L-glutamine. Each of these three treatments uses different mechanisms to improve patient outcomes, offering important options for patients. However, even under favorable modeling assumptions, and benefitting from new data from patients and a curated real-world evidence database, the list prices set for crizanlizumab and voxelotor appear too high to align fairly with clinical benefits.
Policymakers will need to consider the broader clinical and social context when translating this evidence into pricing and coverage, a task of special importance given that these interventions are the first in several decades to advance care in this therapeutic area. ICER will be holding a live webcast on March 26 to discuss the clinical evidence, the economic modeling, the patient perspective, and all related policy implications.
EXCELSIOR ACTION POINT: Although these drugs may improve outcomes, the list prices for crizanlizumab and voxelotor appear too high to align fairly with clinical benefits. L-glutamine appears to be borderline cost-effective for patients who experience at least 10 acute pain crises per year. We hope that the spotlight that ICER shines will encourage the manufacturers of these products to reduce their respective list prices to meet cost-effectiveness targets. Finally, scenario analyses suggest treatment is most cost effective for patients with higher rates of acute pain crises. For example, patients who experience 10 acute pain crises per year may have a cost per QALY as low as $144,000 with L-glutamine.
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