Hello, everyone, and welcome to this edition of Excelsior Solutions’ ICER Update.
Here is this week’s ICER recap:
- This week, ICER published a white paper outlining the potential advantages and disadvantages of three alternatives to the rebate model that currently drives pharmaceutical price negotiation in the US. The paper, created as part of ICER’s membership program, aims to guide policymakers as they consider multiple reform options, including those recently proposed by the Trump Administration.
EXCELSIOR ACTION POINT: This white paper provides good background on the role and impact of rebates in different markets and on different stakeholders. It does a nice job of describing the status quo and in laying out some potential alternative approaches going forward but is somewhat naïve regarding the extent to which some of those alternatives have already been extant in the marketplace. ICER is an increasingly prominent voice in Washington, and this white paper will likely be read by many there who are working on policy and regulatory changes surrounding how pharmaceutical rebates will be managed going forward. This white paper is worth the time needed to read its fewer than 40 pages.
- ICER released a Draft Evidence Report assessing the clinical effectiveness and value of siponimod (Mayzent™, Novartis) for the treatment of secondary progressive multiple sclerosis (SPMS). This draft report will be open to public comment until 5pm ET on April 10, 2019. Based on stakeholder feedback, ICER may revise key assumptions and findings for its Evidence Report, which will be published on May 2, 2019. The Evidence Report will be subject to deliberation during a public meeting of the Midwest Comparative Effectiveness Public Advisory Council (Midwest CEPAC), one of ICER’s three independent evidence appraisal committees, on May 23, 2019.
EXCELSIOR ACTION POINT: Second only to the broad area of oncology, there are likely to be more specialty drugs approved over the next year for the treatment of multiple sclerosis than for any other disease category. Mayzent is the first of several that will warrant your P&T Committee’s attention.
If you would like to discuss these ICER activities, 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 week!
Bob has more than 30 years of diverse experience in the pharmacy industry. Over the course of his career, Bob has led clinical and PBM operations teams in successfully managing more than $4 billion in annual drug spend. This was also while limiting per-member-per-year spending growth to levels that have simultaneously drawn industry acclaim and consistently high levels of member and payer satisfaction.